BMC Psychiatry. 2012 Jun 6;12:57. doi: 10.1186/1471-244X-12-57.
The prevalence of depression in people with a visual disability is high but screening for depression and referral for treatment is not yet an integral part of visual rehabilitation service provision. One reason for this may be that there is no good evidence about the effectiveness of treatments in this patient group. This study is the first to evaluate the effect of depression treatments on people with a visual impairment and co morbid depression.
METHODS /DESIGN: The study is an exploratory, multicentre, individually randomised waiting list controlled trial. Participants will be randomised to receive Problem Solving Therapy (PST), a 'referral to the GP' requesting treatment according to the NICE's 'stepped care' recommendations or the waiting list arm of the trial. The primary outcome measure is change (from randomisation) in depressive symptoms as measured by the Beck's Depression Inventory (BDI-II) at 6 months. Secondary outcomes include change in depressive symptoms at 3 months, change in visual function as measured with the near vision subscale of the VFQ-48 and 7 item NEI-VFQ at 3 and 6 months, change in generic health related quality of life (EQ5D), the costs associated with PST, estimates of incremental cost effectiveness, and recruitment rate estimation.
Depression is prevalent in people with disabling visual impairment. This exploratory study will establish depression screening and referral for treatment in visual rehabilitation clinics in the UK. It will be the first to explore the efficacy of PST and the effectiveness of NICE's 'stepped care' approach to the treatment of depression in people with a visual impairment.
ISRCTN46824140.
视力障碍人群中抑郁症的患病率很高，但目前尚未将抑郁症筛查和治疗转诊作为视觉康复服务的一个组成部分。造成这种情况的一个原因可能是，针对该患者群体的治疗方法并没有很好的疗效证据。本研究首次评估了针对视力障碍合并抑郁症患者的抑郁症治疗方法的效果。
方法/设计：这是一项探索性、多中心、个体随机化等待名单对照试验。参与者将被随机分配接受问题解决疗法（PST）、“根据 NICE 的‘阶梯式护理’建议转介给全科医生”或试验的等待名单组。主要结局测量指标为贝克抑郁量表（BDI-II）在 6 个月时评估的抑郁症状变化（从随机分组开始）。次要结局包括 3 个月时抑郁症状的变化、VFQ-48 的近视力子量表和 7 项 NEI-VFQ 在 3 个月和 6 个月时评估的视觉功能变化、通用健康相关生活质量（EQ5D）的变化、PST 相关成本、增量成本效益估计，以及招募率估计。
在视力障碍人群中，抑郁症很常见。这项探索性研究将在英国的视觉康复诊所建立抑郁症筛查和治疗转诊机制。这将是首次探索 PST 的疗效以及 NICE 的“阶梯式护理”方法在治疗视力障碍患者抑郁症方面的有效性。
ISRCTN46824140。
