The alliance against depression: 2-year evaluation of a community-based intervention to reduce suicidality

• Published in: Psychological medicine 2006-09, Vol.36 (9), p.1225-1233
• Main Authors: HEGERL, ULRICH, ALTHAUS, DAVID, SCHMIDTKE, ARMIN, NIKLEWSKI, GUENTER
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Biological and medical sciences; Catchment Area (Health); Community based treatment; Community health care; Community Mental Health Services - organization & administration; Community Mental Health Services - standards; Depression; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - therapy; Efficacy; Germany - epidemiology; Humans; Intervention; Medical sciences; Mental depression; Mental health care; Middle Aged; Mood disorders; Original Article; Outreach programmes; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Suicidal ideation; Suicide; Suicide, Attempted - prevention & control; Suicide, Attempted - statistics & numerical data; Suicides & suicide attempts; Surveys and Questionnaires; Time Factors
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S003329170600780X

Background. The global burden and large diagnostic and therapeutic deficits associated with depressive disorders call for intervention programs. The aim of the Nuremberg Alliance against Depression (NAD) is to establish and to assess the effectiveness of a four-level intervention program for improving the care of patients with depression. Method. A 2-year intervention program was performed in Nuremberg (480000 inhabitants) at four levels: training of family doctors and support through different methods; a public relations campaign informing about depression; cooperation with community facilitators (teachers, priests, local media, etc.); and support for self-help activities as well as for high-risk groups. The effects of the 2-year intervention on the number of suicidal acts (completed suicides plus suicide attempts, main outcome criterion) were evaluated with respect to a 1-year baseline and a control region (Wuerzburg, 270000 inhabitants). Results. Compared to the control region, a reduction in frequency of suicidal acts was observed in Nuremberg during the 2-year intervention (2001 v. 2000: −19·4%; p[les ]0·082; 2002 v. 2000: −24%, p[les ]0·004). Considering suicide attempts only (secondary outcome criterion), the same effect was found (2001 v. 2000: −18·3%, p[les ]0·023; 2002 v. 2000: −26·5%, p