Abstract
Despite considerable advances in the evidence-based treatments, the long-term management of depressive disorders remains a challenge. Many depressive disorders follow a chronic or recurrent course. Substantial proportions of patients end treatment, especially those with residual symptoms, leave treatment with considerable risk for relapses and/or persistent psychosocial impairment. Long-term strategies are needed that can effectively help patients minimize the negative consequences of their illness without imposing a too much of an extra burden. We present the protocol of a multi-center RCT on the efficacy of an Internet based disease management strategy for the specific health conditions in recurrent depression. 234 patients who are treated for their minimum third episode of a major depression (MD) in one of the six participating centers will participate post-treatment in one of two internet delivered interventions or usual care alone. The interventions continue over 12 months and consist of supportive monitoring, an online forum for peer support, and individual crisis management either with or without personal clinical support. Primary outcome of the trial is the ratio of “well” to “unwell weeks” over a 24-month observation period after index treatment assessed with the Longitudinal Interval Follow-Up Evaluation. We would like to discuss the new options that information and communication technology offers for long-term disease management strategies for patients with recurrent depression and invite for a discussion about strategies for other chronic mental disorders.
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