In the United Kingdom, 1.24 million people suffer from depression annually. For a large proportion of these people, it is not the first time that they have a depressive episode. The relapse into depression is a major problem that occurs in 50 to 75% of people with previous depressive episodes. If depression returns it causes great suffering, loss of social roles, unproductiveness and high costs for society (estimated to be 7.5 billion pounds in the UK), in addition to risk of suicide and the risk of becoming a chronic depressive episode.
Researchers from the University Medical Center Groningen, UMC Brain Center Rudolf Magnus and the University of Oxford aim to test whether early detection of likely relapse into depression can achieve at least 30% fewer full episodes.
Lead researcher Dr. Ruhé explains: "When a relapse into depression is coming people most often gradually deteriorate. A full-blown depressive episode might then be preventable when proper interventions are started in time."
It is like sitting on top of a slide and sliding forward a bit, but being able to keep control just before sliding down. There, you can still back up. But if you really start sliding down, then there is no turning back. And once you have gone down, the depression is a fact and people face a long road to recovery. Therefore, the challenge is to recognize impending relapse earlier. Patients now often only come back into focus when the next depressive episode has developed completely. Their prognosis is then much less favorable.
- Dr Ruhé, University of Groningen
With this study, the researchers want to develop an approach to achieve that someone does not quite slide down, but - once the slide starts - this is recognized more quickly. In addition the researchers aim to teach people skills to help them return back to the top of the slide. The final aim of the study is to reduce the rate of relapses by 30% in the group of patients who participate in the intervention.
What is new in this study is that not only the contents of thought, but also the thought processes (the mindset) on which it is based are goal of this intervention, such as worrying, rumination and constant attention to the "negative". The researchers will be using a smartphone app to offer a cognitive control and a positive attention training. With another app (BeHapp; developed by Prof.dr. Kas and Dr. Vorstman of the UMC Brain Center Rudolf Magnus) they will monitor early signs of an impending decline, to be recognized before a likely relapse. At the suspicion of relapse, the researchers will be using diary measurements to detect any signs of depression. If that is the case then the cognitive and positive attention training is restarted.
The granting of this research contribution is part of the research program ‘Snel Beter Behandelen’ (Faster and Better Treatments) of brain diseases, initiated by the Brain Foundation Netherlands. This program was launched in 2015 to optimize existing therapies and develop new treatments. These treatments must be applied in the clinic within five years. This research is the sixth study granted in this program. The study lasts five years.
The study is conducted under the supervision of:
Dr Ruhé, University of Groningen
Prof Harmer, University of Oxford
Dr Vorstman, UMC Brain Center Rudolf Magnus
Prof Kas, UMC Brain Center Rudolf Magnus/ University of Groningen
Read more about The Brain Foundation Netherlands
Read more about Professor Catherine Harmer