Hermien Elgersma

Publications (2)2.55 Total impact

• Article: Terugvalpreventie bij depressie

  Hermien Elgersma, Claudi Bockting, Gemma Kok
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  ABSTRACT: Elgersma HJ, Bockting CLH, Kok GD. Terugvalpreventie bij depressie. Huisarts Wet 2011;54(2):65–7. Over twintig jaar zal depressie vermoedelijk gestegen zijn naar een tweede plaats op de ranglijst van ziektebeelden die het meeste lijden en kosten met zich meebrengen. Dat komt vooral doordat het een chronische aandoening is terwijl de behandeling zich vooralsnog sterk richt op de acute fase, op ‘cure’ dus. Om een volgende depressieve episode te voorkomen, zijn de meeste patiënten nog steeds aangewezen op een ‘onderhoudsbehandeling’ met antidepressiva, hoewel aangetoond is dat psychologische interventies soms meer bescherming bieden. Vanwege de toenemende persoonlijke en maatschappelijke kosten verdient de preventie van recidiverende depressies extra aandacht. Om de vereiste continuïteit van zorg te realiseren, moeten de eerste en de tweede lijn (de GGZ) meer en beter samenwerken. In dit artikel houden wij twee soorten psychologische interventies tegen het licht die ook in de eerste lijn prima toepasbaar zijn: preventieve cognitieve therapie (PCT) en interventies via internet, e-mental-health. Elgersma HJ, Bockting CLH, Kok GD. Relapse of depression. Huisarts Wet 2011;54(2):65–7. In 20 years, major depressive disorder will probably be the second most burdensome disease in terms of suffering and costs. This is mainly because depression is a chronic disorder, whereas treatment is often given in the acute phase, as a “cure”. Most patients have to rely on maintenance doses of antidepressants to ward off further episodes of depression, even though there is evidence that psychological interventions offer more protection. Given the personal and societal cost of depression, more attention should be given to relapse prevention. Primary and secondary care need to work together to provide continuity of care. This article describes two types of psychological intervention that can be used in primary care: preventive cognitive therapy and E-mental health services and therapies.
  Huisarts en wetenschap 05/2012; 2011(2):65-67.
• Article: Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

  Claudi Bockting, Hermien Elgersma, van Rijsbergen Gerard, de Jonge Peter, Johan Ormel, Erik Buskens, Stant A Dennis, de Jong Peter, Frenk Peeters, Marcus Huibers, Arnoud Arntz, Peter Muris, Willem Nolen, Aart Schene, Steven Hollon
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  ABSTRACT: Abstract Background Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial. Methods/design Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences. Discussion This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT. Trial registration Netherlands Trial Register (NTR): NTR1907
  BMC Psychiatry 01/2011; 11:8. · 2.55 Impact Factor