scholarly journals Depression and anxiety, an Indicated Prevention (DIP) protocol in homes for the elderly: feasibility and (cost) effectiveness of a stepped care programme

2007 ◽  
Vol 7 (1) ◽  
Author(s):  
Els Dozeman ◽  
Digna JF van Schaik ◽  
Aartjan TF Beekman ◽  
Wim AB Stalman ◽  
Judith E Bosmans ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
The Elderly ◽  
Stepped Care ◽  
Depression And Anxiety ◽  
Care Programme ◽  
Indicated Prevention ◽  
Homes For The Elderly

scholarly journals Cost-effectiveness of a stepped care intervention to prevent depression and anxiety in late life: randomised trial

2010 ◽  
Vol 196 (4) ◽  
pp. 319-325 ◽  
Author(s):  
Petronella van't Veer-Tazelaar ◽  
Filip Smit ◽  
Hein van Hout ◽  
Patricia van Oppen ◽  
Henriette van der Horst ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Preventive Intervention ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Cost Effective ◽  
Stepped Care ◽  
Depression And Anxiety ◽  
Care Programme ◽  
Randomised Controlled

BackgroundThere is an urgent need for the development of cost-effective preventive strategies to reduce the onset of mental disorders.AimsTo establish the cost-effectiveness of a stepped care preventive intervention for depression and anxiety disorders in older people at high risk of these conditions, compared with routine primary care.MethodAn economic evaluation was conducted alongside a pragmatic randomised controlled trial (ISRCTN26474556). Consenting individuals presenting with subthreshold levels of depressive or anxiety symptoms were randomly assigned to a preventive stepped care programme (n = 86) or to routine primary care (n = 84).ResultsThe intervention was successful in halving the incidence rate of depression and anxiety at €563 (£412) per recipient and €4367 (£3196) per disorder-free year gained, compared with routine primary care. The latter would represent good value for money if the willingness to pay for a disorder-free year is at least €5000.ConclusionsThe prevention programme generated depression- and anxiety-free survival years in the older population at affordable cost.

scholarly journals Neurological and Neuropsychological Changes Associated with SARS-CoV-2 Infection: New Observations, New Mechanisms

2021 ◽  
pp. 107385842098410
Author(s):  
Muhammad Ali Haidar ◽  
Hussam Jourdi ◽  
Zeinab Haj Hassan ◽  
Ohanes Ashekyan ◽  
Manal Fardoun ◽  
...  
Keyword(s):  
Viral Entry ◽  
Health Workers ◽  
The Elderly ◽  
Circumventricular Organs ◽  
Depression And Anxiety ◽  
Virus Surface ◽  
Angiotensin Converting Enzyme 2 ◽  
Neuropsychological Changes ◽  
High Risk Populations ◽  
The Central Nervous System

SARS-CoV-2 infects cells through angiotensin-converting enzyme 2 (ACE2), a ubiquitous receptor that interacts with the virus’ surface S glycoprotein. Recent reports show that the virus affects the central nervous system (CNS) with symptoms and complications that include dizziness, altered consciousness, encephalitis, and even stroke. These can immerge as indirect immune effects due to increased cytokine production or via direct viral entry into brain tissue. The latter is possible through neuronal access via the olfactory bulb, hematogenous access through immune cells or directly across the blood-brain barrier (BBB), and through the brain’s circumventricular organs characterized by their extensive and highly permeable capillaries. Last, the COVID-19 pandemic increases stress, depression, and anxiety within infected individuals, those in isolation, and high-risk populations like children, the elderly, and health workers. This review surveys the recent updates of CNS manifestations post SARS-CoV-2 infection along with possible mechanisms that lead to them.

scholarly journals Cost-effectiveness of pneumococcal vaccination strategies for the elderly in Korea

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0177342 ◽  
Author(s):  
Jung Yeon Heo ◽  
Yu Bin Seo ◽  
Won Suk Choi ◽  
Jacob Lee ◽  
Ji Yun Noh ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Pneumococcal Vaccination ◽  
The Elderly ◽  
Vaccination Strategies

scholarly journals Stepped care for depression and anxiety in visually impaired older adults: multicentre randomised controlled trial

BMJ ◽  
2015 ◽  
pp. h6127 ◽  
Author(s):  
Hilde P A van der Aa ◽  
Ger H M B van Rens ◽  
Hannie C Comijs ◽  
Tom H Margrain ◽  
Francisca Gallindo-Garre ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomised Controlled Trial ◽  
Visually Impaired ◽  
Controlled Trial ◽  
Stepped Care ◽  
Depression And Anxiety ◽  
Randomised Controlled

scholarly journals Service Use, Drop-Out Rate and Clinical Outcomes: A Comparison Between High and Low Intensity Treatments in an IAPT Service

2014 ◽  
Vol 42 (6) ◽  
pp. 747-759 ◽  
Author(s):  
Stella W. Y. Chan ◽  
Malcolm Adams
Keyword(s):  
Clinical Outcomes ◽  
High Intensity ◽  
Recovery Rate ◽  
Service Use ◽  
Evaluation Study ◽  
Drop Out ◽  
Stepped Care ◽  
Depression And Anxiety ◽  
Low Intensity ◽  
Drop Out Rate

Background: The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher “step-up” rates between low and high intensity treatments. Aims: This study aimed to compare the two intensity groups in an IAPT service in Suffolk. Method: This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments. Results: The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms. Conclusions: Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.

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