Cluster Randomized Trial of Stepped Care Intervention vs. Treatment as Usual for Patients With Depression (SCM)
Depression
About this trial
This is an interventional treatment trial for Depression focused on measuring depression, stepped care, evidence-based medicine, health services research, psychotherapy, complex intervention, guideline
Eligibility Criteria
Inclusion Criteria:
- >4 points on PHQ-D-9 depression scale
- sufficient knowledge of German language
- health situation that allows questionnaire completion
Exclusion Criteria:
- insufficient knowledge of German language
- health situation not allowing questionnaire completion
Sites / Locations
- Centre for Psychosocial Medicine, Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Stepped care intervention (SCM)
Control group: treatment as usual
Patients within the stepped care intervention are screened by general physician using the PHQ-9 (inclusion criterion: >4 points) and diagnosed according to International Classification of Diseases (ICD-10) criteria. Patients receive differentially intensive treatment according to depression severity. Patients with mild depression receive: Step I: Active monitoring or Step II: II.a. Bibliotherapy or II.b. Online self-help ("Deprexis®") or II+: Telephone-based psychotherapy Patients with moderate depression receive: Step III: III.a. Outpatient psychotherapy or III.b. Psychopharmacological treatment Patients with severe depression receive: Step IV: Combined psychotherapy and psychopharmacological treatment, optionally in inpatient setting.
Patients in the control group are screened by their general physician using the PHQ-D-9 depression scale. Patients included in the study then receive treatment as usual from general physician or other health service providers.