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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2012; 12: 57.
Published online 2012 July 12. doi:  10.1186/1471-244X-12-57
PMCID: PMC3395562
Copyright ©2012 Margrain et al.; licensee BioMed Central Ltd.
The Depression in Visual Impairment Trial (DEPVIT): trial design and protocol
Tom H Margrain,corresponding author1 Claire Nollett,1 Julia Shearn,1 Miles Stanford,3 Rhiannon Tudor Edwards,4 Barbara Ryan,1 Catey Bunce,5 Robin Casten,6 Mark T Hegel,7 and Daniel J Smith2
1School of Optometry and Vision Sciences, Cardiff University, Cardiff, CF24 4LU, UK
2Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK
3Eye (Ophthalmology) team, South Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
4Centre for Economics and Policy in Health/Canolfan Economeg a Pholisi Iechyd IMSCaR, College of Health and Behavioural Sciences, Bangor University, Dean Street Building, Gwynedd, LL57 1UT, UK
5Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK
6Department of Psychiatry and Human Behaviour, Jefferson Medical College, Philadelphia, USA
7Department of Psychiatry, Dartmouth Medical School, Hanover, NH, USA
corresponding authorCorresponding author.
Tom H Margrain: margrainth/at/cardiff.ac.uk; Claire Nollett: nollettcl/at/cardiff.ac.uk; Julia Shearn: Shearnj/at/cardiff.ac.uk; Miles Stanford: miles.stanford/at/kcl.ac.uk; Rhiannon Tudor Edwards: r.t.edwards/at/bangor.ac.uk; Barbara Ryan: ryanb/at/cardiff.ac.uk; Catey Bunce: c.bunce/at/ucl.ac.uk; Robin Casten: robin.casten/at/jefferson.edu; Mark T Hegel: Mark.T.Hegel/at/hitchcock.org; Daniel J Smith: smithdj3/at/cf.ac.uk
Received December 22, 2011; Accepted June 6, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
The prevalence of depression in people with a visual disability is high but screening for depression and referral for treatment is not yet an integral part of visual rehabilitation service provision. One reason for this may be that there is no good evidence about the effectiveness of treatments in this patient group. This study is the first to evaluate the effect of depression treatments on people with a visual impairment and co morbid depression.
Methods /design
The study is an exploratory, multicentre, individually randomised waiting list controlled trial. Participants will be randomised to receive Problem Solving Therapy (PST), a ‘referral to the GP’ requesting treatment according to the NICE’s ‘stepped care’ recommendations or the waiting list arm of the trial. The primary outcome measure is change (from randomisation) in depressive symptoms as measured by the Beck’s Depression Inventory (BDI-II) at 6 months. Secondary outcomes include change in depressive symptoms at 3 months, change in visual function as measured with the near vision subscale of the VFQ-48 and 7 item NEI-VFQ at 3 and 6 months, change in generic health related quality of life (EQ5D), the costs associated with PST, estimates of incremental cost effectiveness, and recruitment rate estimation.
Discussion
Depression is prevalent in people with disabling visual impairment. This exploratory study will establish depression screening and referral for treatment in visual rehabilitation clinics in the UK. It will be the first to explore the efficacy of PST and the effectiveness of NICE’s ‘stepped care’ approach to the treatment of depression in people with a visual impairment.
Trial registration
ISRCTN46824140
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