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Depression in visual impairment trial (DEPVIT): a randomised clinical trial of depression treatments in people with low vision

Nollett, Claire, Bray, Nathan, Bunce, Catey, Casten, Robin J., Edwards, Rhiannon, Hegel, Mark T., Janikoun, Sarah, Jumbe, Sandra, Ryan, Barbara, Shearn, Julia, Smith, Daniel J., Stanford, Miles, Xing, Wen and Margrain, Thomas Hengist 2016. Depression in visual impairment trial (DEPVIT): a randomised clinical trial of depression treatments in people with low vision. Investigative Ophthalmology and Visual Science 57 (10) , pp. 4247-4254. 10.1167/iovs.16-19345

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Abstract

Purpose: The purpose of this study was to compare two interventions for depression, problem solving treatment (PST) and referral to the patient's physician, with a waiting-list control group in people with sight loss and depressive symptoms. Methods: This was an assessor-masked, exploratory, multicenter, randomized clinical trial, with concurrent economic analysis. Of 1008 consecutive attendees at 14 low-vision rehabilitation centers in Britain, 43% (n = 430) screened positive for depressive symptoms on the Geriatric Depression Scale and 85 of these attendees participated in the trial. Eligible participants were randomized in the ratio 1:1:1 to PST, referral to their physician, or a waiting-list control arm. PST is a manualized talking intervention delivered by a trained therapist who teaches people over six to eight sessions to implement a seven-step method for solving their problems. Referral to the physician involved sending a referral letter to the person's physician, encouraging him or her to consider treatment according to the stepped care protocol recommended by the U.K.'s National Institute of Health and Care Excellence. The primary outcome was change in depressive symptoms (6 months after baseline) as determined by the Beck Depression Inventory. Results: At 6 months, Beck Depression Inventory scores reduced by 1.05 (SD 8.85), 2.11 (SD 7.60), and 2.68 (SD 7.93) in the waiting-list control, referral, and PST arms, respectively. The cost per patient of the PST intervention was £1176 in Wales and £1296 in London. Conclusions: Depressive symptoms improved most in the PST group and least in the control group. However, the change was small and the uncertainty of the measurements relatively large.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Optometry and Vision Sciences
Subjects: R Medicine > RE Ophthalmology
Publisher: Association for Research in Vision and Ophthalmology
ISSN: 0146-0404
Funders: Guide Dogs
Date of First Compliant Deposit: 27 July 2016
Date of Acceptance: 9 June 2016
Last Modified: 28 Jun 2019 03:30
URI: http://orca.cf.ac.uk/id/eprint/93372

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