Treatment of Depression

Established: 2004

Convenor (Chair): Professor Tony Kendrick, Professor of Primary Medical Care at Southampton

Members: Chris Dowrick (University of Liverpool); Tony Kendrick (University of Southampton); Helen Lester (University of Birmingham), Glyn Lewis (University of Bristol), Debbie Sharp (University of Bristol) and others.

Remit and Aims:
Initially, the aim of the group was to develop new research on antidepressants, but following its first meeting the remit has been widened to include other treatments for depression, including psychological treatments and guided self-help, since antidepressants are not usually used in isolation. The group aims to conduct some observational studies to determine the incidence of depression presenting in primary care; the determinants of GP diagnostic decisions; prescribing rates for new diagnoses of depression; levels of adherence to medication; rates of switching between types of antidepressants; outcomes of treatment; predictors of outcome; and the development of long-term use and whether this is justified.

Current Status & Future Plans:
The group met twice in 2004 and twice in 2005. Progress is being made on a number of collaborative projects.
• Observational studies are being worked up by Tony Kendrick, Glyn Lewis & Debbie Sharp.
• Chris Dowrick is leading a qualitative study on the feasibility of conducting a balanced placebo controlled trial of antidepressants. Qualitative interviews and focus groups are addressing the ethical issues around the need to mislead participants by telling them in half of the cases that they are taking placebos when they are taking antidepressants, and vice versa. If these issues can be resolved, the plan is to conduct a balanced placebo controlled trial in a number of centres.
• Dave Richards and colleagues are conducting an exploratory trial of case management for depression, funded by an MRC trial platform grant. Steve Pilling and colleagues (of UCL) are also conducting a trial of case management. The Depression Treatment Research Group plans to bid for funding from the MRC for a definitive multi-centre trial of enhanced care for depression, building on the experience of these two projects. Discussions are taking place with potential NHS Trust and commercial partners with the aim of joining the study.
• Members of the group are helping identify qualitative datasets already in existence from previous studies of people with depression, looking at issues around the meaning of depression and what works for sufferers. The aim is to conduct secondary analyses of these datasets, which would include a wide range of geographical areas and types of participant. A funding bid for this secondary analysis will be prepared in due course.
• Several proposals are under consideration by commerical companies.