Meiser Bettina, Schofield Peter R, Trevena Lyndal, Wilde Alex, Barlow-Stewart Kristine, Proudfoot Judy, Peate Michelle, Dobbins Timothy, Christensen Helen, Sherman Kerry A, Karatas Janan, Mitchell Philip B
Psychosocial Research Group, Prince of Wales Clinical School, The University of New Sourth Wales, Sydney, NSW 2052, Australia.
BMC Psychiatry. 2013 Dec 1;13:325. doi: 10.1186/1471-244X-13-325.
The strongest risk factor for depression is having a family history of the condition. Many individuals with a family history of depression are concerned about their personal risk for depression and report unmet educational and psychological support needs. No supportive and/or educational interventions are currently available that target this group of individuals. In this study we will develop and evaluate the first online psycho-educational intervention targeted to individuals with a family history of depression. Genetic risk information and evidence-rated information on preventive strategies for depression will be provided to such individuals in a general practice setting. The intervention will also incorporate a risk assessment tool. The content and delivery of the intervention will be pilot-tested.
METHODS/DESIGN: The proposed intervention will be evaluated in the general practitioner (GPs) setting, using a cluster randomized controlled trial. GP practices will be randomized to provide either access to the online, targeted psycho-educational intervention or brief generic information about depression (control) to eligible patients. Eligibility criteria include having at least one first-degree relative with either major depressive disorder (MDD) or bipolar disorder (BD). The primary outcome measure is 'intention to adopt, or actual adoption of, risk-reducing strategies'. Secondary outcome measures include: depression symptoms, perceived stigma of depression, knowledge of risk factors for development of depression and risk-reducing strategies, and perceived risk of developing depression or having a recurrence of family history. Over the course of the study, participants will complete online questionnaires at three time points: at baseline, and two weeks and six months after receiving the intervention or control condition.
This novel psycho-educational intervention will provide individuals with a family history of depression with information on evidence-based strategies for the prevention of depression, thus, we hypothesize, enabling them to make appropriate lifestyle choices and implement behaviors designed to reduce their risk for depression. The online psycho-educational intervention will also provide a model for similar interventions aimed at individuals at increased familial risk for other psychiatric disorders.
The study is registered with the Australian and New Zealand Clinical Trials Group (Registration no: ACTRN12613000402741).
抑郁症最强的风险因素是有该病的家族病史。许多有抑郁症家族病史的人担心自己患抑郁症的个人风险，并表示他们在教育和心理支持方面的需求未得到满足。目前没有针对这一群体的支持性和/或教育性干预措施。在本研究中，我们将开发并评估首个针对有抑郁症家族病史者的在线心理教育干预措施。将在全科医疗环境中向这类个体提供抑郁症遗传风险信息以及经循证的抑郁症预防策略信息。该干预措施还将纳入一个风险评估工具。干预措施的内容和实施方式将进行预试验。
方法/设计：拟实施的干预措施将在全科医生（GP）环境中进行评估，采用整群随机对照试验。GP诊所将被随机分组，为符合条件的患者提供在线针对性心理教育干预措施，或提供关于抑郁症的简短一般性信息（对照组）。纳入标准包括至少有一位患有重度抑郁症（MDD）或双相情感障碍（BD）的一级亲属。主要结局指标是“采用或实际采用降低风险策略的意向”。次要结局指标包括：抑郁症状、对抑郁症耻辱感的认知、对抑郁症发病风险因素和降低风险策略的了解，以及对患抑郁症或家族病史复发的感知风险。在研究过程中，参与者将在三个时间点完成在线问卷：基线时、接受干预或对照条件后两周和六个月。
这种新颖的心理教育干预措施将为有抑郁症家族病史的个体提供基于循证策略预防抑郁症的信息；因此，我们推测这将使他们能够做出适当的生活方式选择，并实施旨在降低抑郁症风险的行为。在线心理教育干预措施还将为针对其他精神疾病家族风险增加个体的类似干预措施提供一个模式。
该研究已在澳大利亚和新西兰临床试验组注册（注册号：ACTRN12613000402741）。
