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APRAND programme: an intervention to prevent relapses of anxiety and depressive disorders: First results of a medical health promotion intervention in a population of employees

Published online by Cambridge University Press:  16 April 2020

C. Godard ,
A. Chevalier ,
Y. Lecrubier  and
G. Lahon
C. Godard*
Affiliation:
Service Général de Médecine de Contrôle of EDF GDF, 22-28, rue Joubert, 75009Paris, France
A. Chevalier
Affiliation:
Service Général de Médecine de Contrôle of EDF GDF, 22-28, rue Joubert, 75009Paris, France INVS, Department “Santé-travail”, 12, rue du Val d’Osne, 94415, St Maurice, France
Y. Lecrubier
Affiliation:
Inserm—Unité 302, La Salpetrière, Pavillon Clérambault, 47, Boulevard de l’Hôpital, 75651Paris cedex 13, France INVS, Department “Santé-travail”, 12, rue du Val d’Osne, 94415, St Maurice, France
G. Lahon
Affiliation:
Service Général de Médecine de Contrôle of EDF GDF, 22-28, rue Joubert, 75009Paris, France INVS, Department “Santé-travail”, 12, rue du Val d’Osne, 94415, St Maurice, France
*
*Corresponding author. E-mail addresses: [email protected] (C. Godard), [email protected] (A. Chevalier), [email protected] (Y. Lecrubier), [email protected] (G. Lahon).
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Abstract

Objective

The study sought to determine whether an organized health promotion intervention during medical consultations improves the outcome for patients who meet the ICD10 criteria for anxiety or depressive disorders.

Methods

In 2001, physicians used the MINI to screen 9743 employees on sick leave and consulting physicians in 21 medical centres of a large company. A health promotion intervention was implemented in eight “active” centres. It took place immediately after diagnosis and consisted of explaining the disorders, delivering the test results and leaflets based on WHO recommendations, and advising patients to consult their personal physician, psychiatrist or occupational physician, if necessary. Its effectiveness, evaluated by symptom severity and outcome over 1 year, was assessed by comparing the eight active centres to 13 control centres (without the intervention).

Results

Disorders were detected among 10.6% of the subjects, 29.4% of whom had no previous diagnosis of anxiety or depressive disorder. The intervention was associated with a positive effect on the 6-week and 6-month HAD scores. Total absence of disorders at 1 year was associated with age, sex, and intervention, among all identified cases (OR = 1.53), among those with at least one anxiety disorder (OR = 1.45), and among those with at least one depressive disorder (OR = 1.40).

Conclusion

Combining detection with organized provision of information including printed material improves patients' outcome and physicians' diagnostic abilities.

Keywords

AnxietyDepressionHealth promotionCluster intervention study
Type
Original article
Information
European Psychiatry , Volume 21 , Issue 7 , October 2006 , pp. 451 - 459
Copyright
Copyright © Elsevier SAS 2006

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References

Andews, G., Sanderson, K., Slade, T., Issakidis, C.Why does the burden of disease persist? Relating the burden of anxiety and depression to effectiveness of treatment Bull. World health Organisation 78(4)2000 446–453.Google Scholar
Anguis, M., Roelandt, JL, Caria, A. La perception des problèmes de santé mentale: les résultats d’une enquête sur neuf sites, Drees, Etudes et Résultats, n°347, octobre 2004.Google Scholar
Barkow, K., Heun, R., Wittchen, H.U., Bedirhan Ustun, T., Gansicke, M., Maïer, W.Mixed anxiety-depression in a 1 year follow-up study: shift to other diagnoses or remission? J. Affect. Disord. 79(1-3)2004 235–239.CrossRefGoogle ScholarPubMed
Barkow, K., Heun, R., Ustun, T.B., Berger, M., Bermejo, I., Gaebel, W.et al.Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care Eur. Psychiatry 19(5)2004 250–257.CrossRefGoogle ScholarPubMed
Barkow, K., Maïer, W., Ustun, T.B., Gansicke, M., Wittchen, H.U., Heun, R.Risk factors for depression at 12-month follow-up in adult primary health care patients with major depression: an international prospective study J. Affect. Disord. 76(1-3)2003 157–169.CrossRefGoogle ScholarPubMed
Berkels, H, Henderson, J, Henke, N, Kuhn, K, Lavikainen, J, Lehtinen, V, et al. Mental health promotion and prevention strategies for coping with anxiety, depression and stress related disorders in Europe. Federal Institute for Occupational Safety and Health. Final report 2004, 125p.Google Scholar
Brunello, N., Den Boer, J.A., Judd, L.L., Kasper, S.et al.Social phobia: diagnosis and epidemiology, neurobiology and pharmacology, comorbidity and treatment J. Affect. Disord. 60(1)2000 61–74.CrossRefGoogle ScholarPubMed
Chevalier, A., Bonenfant, S., Picot, M.C., Chastang, J.F., Luce, D.Occupational factors of anxiety and depressive disorders in the french national electricity and Gaz company JOEM 1996; 38:(N°11, nov)Google ScholarPubMed
Donoghue, J.M., Tylee, A.The treatment of depression: prescribing patterns of antidepressants in primary care in the UK Br. J. Psychiatry 168(2)1996 164–168.CrossRefGoogle ScholarPubMed
Dowrick, C., Dunn, G., Ayuso-Mateos, J.L.et al.Problem solving treatment and group psychoeducation for depression: multicentre randomised controlled trial BMJ 2000; 312:Google Scholar
Geddes, J., Carney, S., Davies, C.et al.Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review Lancet 2003; 361CrossRefGoogle ScholarPubMed
Goldberg, M., Leclerc, A.Cohorte GAZEL 20000 volontaires d’EDF-GDF pour la recherche médicale. Bilan 1989–1993 Paris: les éditions de l’INSERM; 1994.Google Scholar
Kessler, R.C., Berglund, P.A., Dewit, D.J., Ustun, T.B., Wang, P.S., Wittchen, H.U.Distinguishing generalized anxiety disorder from major depression: prevalence and impairment from current pure and comorbid disorders in the US and Ontario Int. J. Methods Psychiatr. Rs 11(3)2002 99–111.CrossRefGoogle ScholarPubMed
Lecrubier, Y., Ustun, T.B.Panic and depression, a worldwide primary care perspective Int. Clin. Psychopharmacol. 13(Suppl 4)1998 S7–S11.Google ScholarPubMed
Lecrubier, Y., Boyer, P., Lépine, J.P., Weiller, E.Results from the Paris centre. Ustün, T.B., Sartorius, N., Mental illness in general health care New York: Wiley and Sons; 1995. 211–225.Google Scholar
Lecrubier, Y., Sheehan, D.V., Weiller, E.et al. The Mini International Neuropsychiatric Interview (MINI). A short structured interview: reliability and validity according to the CIDI Eur. Psychiatry 1997; 12:224–231.CrossRefGoogle Scholar
Le Pape, A, Lecomte, T, Prévalence et prise en charge médicale de la dépression en 1996-1997. Irdes, Biblio n° 1277, Septembre 1999.Google Scholar
Lépine, J.P., Gastpar, M., Mendelewicz, J., Tylee, A.Depression in the Community: the First Pan-European Study DEPRES (Depression Research in European Society) Int. Clin. Psychopharmacol. 1997; 12:19–20.CrossRefGoogle Scholar
Maier, W., Gansicke, M., Freyberger, H.J., Linz, M., Heun, R., Lecrubier, Y.Generalized anxiety disorder (ICD10) in primary care from a cross-cultural perspective: a valid diagnostic entity? Acta Psychiatr. Scand. 101(1)2000 29–36.CrossRefGoogle Scholar
McAlpine, D., Wilson, A.Screening for depression in primary care: what do we still need to know? Depress. Anxiety 2004; 19:137–145.CrossRefGoogle ScholarPubMed
Olie, J.P., Elomari, F., Spatone, C.Lepine JP—Antidepressants consumption in the global population in France Encephale 28(5 Pt 1)2002 411–417.Google ScholarPubMed
Paykel, E.S., Tylee, A., Wright, A., Priest, R.G., Rix, S., Hart, D.The defeat depression campaign: psychiatry in the public arena Am. J. Psychiatry 154(6suppl)1997 59–65.Google ScholarPubMed
Priest, R.G., Vize, C., Roberts, A., Tylee, A.Lay peoples attiudes to treatment of depression: results of opinion poll for Defeat Depression Campagn just before its launch BMJ 313(7061)1996 858–859.CrossRefGoogle Scholar
Pull, CB, Caria, A, Chaillet, G, Pull, MC, Quemada, N, Staner, L. CIM-10, Chapître V, Version 24 cartes pour médecins généralistes pour les études sur le terrain. Traduction française 1996.Google Scholar
Rihmer, Z., Rutz, W., Philgren, H.Depression and suicide in Gotland, An intensive Study of all Suicides before and after depression-training programme for General Practitioners J. Affect. Disord. 1995; 354:147–152.CrossRefGoogle Scholar
Rix, S., Paykel, E.S., Lelliott, P.et al.Impact of a national campaign on GP education: an evaluation of the defeat depression campaign Br. J. Gen. Pract. 49(439)1999 91–92.Google ScholarPubMed
Rutz, W.Improvement of care for people suffering from depression: the need for comprehensive education Int. clin. Psychopharmacol. 14(Suppl 3)1999 S27–S33.CrossRefGoogle ScholarPubMed
Rutz, W.Preventing suicide and premature death by education and treatment J. Affect. Disord. 62(1–2)2001 123–129.CrossRefGoogle ScholarPubMed
Rutz, W., Carlson, P., von Knoring, L., Walinder, J.Cost benefit analysis of an educational program for general practitioners by the Swedish Committee for the Prevention and Treatment of Depression Acta Psychiatr. Scand. 85(6)1992 457–464.CrossRefGoogle ScholarPubMed
Sheehan, D.V., Lecrubier, Y., Harnett-Sheehan, K.et al.Reliability and Validity of the MINI International Neuropsychiatric Interview (MINI): According to the SCID-P Eur. Psychiatry 1997; 12:232–241.CrossRefGoogle Scholar
Simon, G.E.Long-term prognosis of depression in primary care Bull. World Health Organisation 78(4)2000 439–445.Google ScholarPubMed
Simon, G.E., Goldberg, D., Tiemens, B.G., Ustun, T.B.Outcomes of recognized and unrecognized depression in an international primary care study Gen. Hosp. Psychiatry 21(2)1999 97–105.CrossRefGoogle Scholar
Singleton, A., Tylee, A.Continuing medical education in mental illness: a paradox for general practitioners Br. J. Gen. Pract. 46(412)1996. 690.Google ScholarPubMed
The ESEMed/MHEDEA 2000 investigations. sampling and methods of the European Study of the Epidemiology of Mental Disorders project Acta Psychiatr. Scand. 109(Suppl.420)2004 8–20.CrossRefGoogle Scholar
Tylee, A.Depression in the community: physician and patient perspective J. clin. psychiatry 60(suppl 7)1999 12–16. (discussion17-8)Google ScholarPubMed
Tylee, A.Depression in Europe: experience from the DEPRESII survey. Depression research in the European Society Eur. psychopharmacol. 10(Suppl 4)2000 S445–S448.Google Scholar
Tylee, A., Gaspar, M., Lépine, J.P., Mendlewicz, J.DEPRESII (Depression Research in European Society): a patient survey of the symptoms, disability and current management of depression in the community Int. Clin. Psychopharmacol. 1999; 14:139–151.Google Scholar
Tylee, A., Gaspar, M., Lépine, J.P., Mendlewicz, J.DEPRESII (Depression Research in European Society): identification of depressed patient types in the community and their treatment needs Int. Clin. Psychopharmacol. 1999; 14:153–165.Google Scholar
Ukoumunne, O., Gulliford, M., Chinn, S., Sterne, J., Burney, P., Donner, A.Methods in health service research: evaluation of health interventions at area and organisation level BMJ 1999; 319:376–379.CrossRefGoogle ScholarPubMed
Ustun, T.B.The global burden of mental disorders Am. J. Public Health 89(9)1999 5–8.CrossRefGoogle ScholarPubMed
Ustun, T.B.Who perspectives on international classification Psychopathology 35(2-3)2002 62–66.CrossRefGoogle ScholarPubMed
Zigmond, A.S., Snait, R.P.The hospital anxiety and depression scale Acta Psychiatr. Scand. 67(6)1983 361–370.CrossRefGoogle ScholarPubMed
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