Depression and Anxiety
Objectives
The EMGO institute is very well positioned in mental health. Within the mental health program we have a long tradition of community-based epidemiological studies and innovative work regarding mental health promotion and prevention. This draws on the expertise of the collaborating departments, collaboration with the municipal health department, the National Institute of Mental Health and Addiction and the access to prevention departments of collaborating mental health institutions. This currently functions as an official academic workplace for mental health research. Simultaneously, much is invested in training both researchers (within EMGO) and the relevant professionals (GPs, psychiatrists, psychologists), with the overall objective to provide an environment in which research and vocational training strengthen and inspire each other.
Collaborations
With regard to primary mental health care, the collaboration between key players in the field and access to both networks of GP practices and the neighbouring departments of mental health institutions has provided and excellent environment for both innovation and research. In terms of research this has lead to a series of longer lasting and large scale observational studies (such as NESDA and LASA), the results of which are systematically used to study effects of innovations in practice (a series of trials testing both preventative and curative interventions concerning mental health conditions in the primary care setting).
With regard to specialised mental health the group is embedded within GGZ ingeest, which is a large (2300 employees) mental health institution, covering the region surrounding the VUmc. Within SBG, several academic workplaces are in place. These concern the very patient groups which are most relevant to the EMGO mental health programme (anxiety disorders, depression, old age psychiatry, bipolar disorder and psychotic disorders). Again, within these academic workplaces research, innovation of care and training of professionals are conducted side by side, providing an excellent environment for all three activities.
Results
Through the infrastructure of the academic workplace for Mental Health, various prevention and treatment trials have been conducted in the past. A recent example is a stepped care prevention trial conducted among elderly (>75) primary care patients. The trial demonstrated that prevention of depression and anxiety is both feasible and effective (more than 50% reduction in the incidence of DSM anxiety or depressive disorders) (Nelleke van ’t Veer 2009). Other examples include treatment effect studies in patients with various anxiety disorders and depression. Currently, in specialized mental health care, a specialized intervention (‘CBASP’) for chronic depressed subjects is being examined in a randomized controlled trial (Wiersma et al. 2008). For results from the Longitudinal Aging Study Amsterdam (LASA) and the Netherlands Study of Depression and Anxiety (NESDA) we refer to these respective project-pages.