Primary Care Group Therapy for Depression/Anxiety for Women in Petropolis
Condition: Depression; Anxiety Disorders
MeSH terms: Depression; Depressive Disorder; Anxiety Disorders
Study type: Interventional
Phase: Phase 3

Summary: 
      This is a randomized controlled trial comparing two groups: 1) Enhanced usual care and 2)
      Enhanced usual care plus group psychological intervention. In both groups a "stepped care"
      approach was used to the management of anxiety and depression among women seen in primary
      care.
    

Detailed description: 
      All patients received enhanced primary care, which included: (1) The nurses and doctors from
      the Family Health Teams were trained by Matrix team mental health professionals on clinical
      aspects of depression and anxiety, including diagnosis, appropriate medication interventions,
      psycho-education, and cognitive and problem solving therapy. (2) Given the high co-occurrence
      of anxiety and depression, the intervention was modified from the depression-only Chile model
      to emphasize co-occurring anxiety and depression in diagnoses, appropriate prescription of
      anxiolytics and antidepressants. (3) All providers received weekly group or individual
      consultation with a Matrix team mental health professional, either psychiatrist or
      psychologist. An qualitative study of participating Petrópolis Family Health Programme
      doctors and nurses demonstrated their satisfaction with the training.

      Patients in the intervention arm received enhanced primary care plus a 9-session group
      intervention (seven sessions weekly then two sessions every 15 days). The intervention
      included two psycho-educational sessions with information about depression and anxiety
      disorders, two sessions on the development of pleasant activities including relaxation
      exercises, two sessions on solving problems therapy, one session on the problem of overcoming
      negative thoughts and emotions, one session on relapse prevention, and a final closure and
      review session which included a small party. The patients from the intervention arm also
      received additional outreach from the Family Health Teams, including home delivery of
      psychotropic medication when needed and active outreach and engagement by community workers
      if patients missed group sessions.
    

Intervention name(s): Psychosocial Group Intervention; Enhanced Usual Care
Intervention type(s): Behavioral; Other
Intervention description(s): The intervention included two psycho-educational sessions with information about depression and anxiety disorders, two sessions on the development of pleasant activities including relaxation exercises, two sessions on solving problems therapy, one session on the problem of overcoming negative thoughts and emotions, one session on relapse prevention, and a final closure and review session which included a small party.; All patients received enhanced primary care: (1) Nurses and doctors from the Family Health Teams were trained by Matrix team mental health professionals on clinical aspects of depression and anxiety. (2) Given the high co-occurrence of anxiety and depression, the intervention was modified from the depression-only Chile model to emphasize co-occurring anxiety and depression in diagnoses, appropriate prescription of anxiolytics and antidepressants. (3) All providers received weekly group or individual consultation with a Matrix team mental health professional, either psychiatrist or psychologist. An qualitative study of participating Petrópolis Family Health Programme doctors and nurses demonstrated their satisfaction with the training.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: All patients received enhanced primary care, which included: (1) The nurses and doctors from the Family Health Teams were trained by Matrix team mental health professionals on clinical aspects of depression and anxiety, including diagnosis, appropriate medication interventions, psycho-education, and cognitive and problem solving therapy. (2) Given the high co-occurrence of anxiety and depression, the intervention was modified from the depression-only Chile model to emphasize co-occurring anxiety and depression in diagnoses, appropriate prescription of anxiolytics and antidepressants.
Masking: None (Open Label)
Primary purpose: Treatment