Open Access Study protocol

Prediction of depression in European general practice attendees: the PREDICT study

Michael King1*, Scott Weich2, Francisco Torres-González3, Igor Švab4, Heidi-Ingrid Maaroos5, Jan Neeleman6, Miguel Xavier7, Richard Morris8, Carl Walker1, Juan A Bellón-Saameño9, Berta Moreno-Küstner3, Danica Rotar4, Janez Rifel4, Anu Aluoja5, Ruth Kalda5, Mirjam I Geerlings6, Idalmiro Carraça10, Manuel Caldas de Almeida11, Benjamin Vicente12, Sandra Saldivia12, Pedro Rioseco12 and Irwin Nazareth13

Author Affiliations

1 Department of Mental Health Sciences, UCL, London, UK

2 Division of Health in the Community, University of Warwick, Coventry, UK

3 Department of Psychiatry, University of Granada, Granada, Spain

4 Dept. of Family Medicine, University of Ljubljana, Ljubljana, Slovenia

5 Faculty of Medicine, University of Tartu, Tartu, Estonia5

6 University Medical Center, Utrecht, Netherlands

7 Faculdade Ciências Médicas, University of Lisbon, Lisbon, Portugal

8 Department of Primary Care and Population Sciences, UCL, London, UK

9 Department of Family and Community Medicine, Malaga, Spain

10 Encarnação Health Centre, Lisbon, Portugal

11 Mora Health Centre, Mora, Portugal

12 Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile

13 Department of Primary Care and Population Sciences, UCL and Scientific Director, Medical Research Council General Practice Research Framework, UCL, London, UK

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BMC Public Health 2006, 6:6  doi:10.1186/1471-2458-6-6

Published: 12 January 2006

Abstract

Background

Prevention of depression must address multiple risk factors. Estimating overall risk across a range of putative risk factors is fundamental to prevention of depression. However, we lack reliable and valid methods of risk estimation. This protocol paper introduces PREDICT, an international research study to address this risk estimation.

Methods/design

This is a prospective study in which consecutive general practice attendees in six European countries are recruited and followed up after six and 12 months. Prevalence of depression is assessed at baseline and each follow-up point. Consecutive attendees between April 2003 and September 2004 who were aged 18 to 75 were asked to take part. The possibility of a depressive episode was assessed using the Depression Section of the Composite International Diagnostic Interview. A selection of presumed risk factors was based on our previous work and a systematic review of the literature. It was necessary to evaluate the test-retest reliability of a number of risk factor questions that were developed specifically, or adapted, for the PREDICT study. In a separate reliability study conducted between January and November 2003, consecutive general practice attendees in the six participating European countries completed the risk factor items on two occasions, two weeks apart. The overall response rate at entry to the study was 69%. We exceeded our expected recruitment rate, achieving a total of 10,048 people in all. Reliability coefficients were generally good to excellent.

Discussion

Response rate to follow-up in all countries was uniformly high, which suggests that prediction will be based on almost a full cohort. The results of our reliability analysis are encouraging and suggest that data collected during the course of PREDICT will have a satisfactory level of stability. The development of a multi-factor risk score for depression will lay the foundation for future research on risk reduction in primary care. Our data will also provide the necessary evidence base on which to develop and evaluate interventions to reduce the prevalence of depression.