Assessing and enhancing resilience to depression in people with long term medical conditions in the era of the current Greek social and financial crisis(ASSERT-DEP)

Project facts

Project promoter:
University of Ioannina(UOI)/Special Account
Project Number:
GR07-0001
Target groups
Disabled
Status:
Completed
Initial project cost:
€200,000
Final project cost:
€153,215
From EEA Grants:
€ 130,233
The project is carried out in:
Ιωάννινα / Ioannina

Description

This project aims to develop psychosocial strategies to enhance resilience to depression in most affected by the current Greek crisis vulnerable patients, through a programme of applied clinical research. Our research plan includes three phases. In Phase 1 we will collect information from approximately 450 people, 300 with 3 chronic illnesses: diabetes, rheumatologic disorders and chronic obstructive pulmonary disease attending follow-up specialty clinics or seeking unscheduled care and 150 alleged healthy controls. It also involves the study of polymorphisms of specific genes relevant to depression. In Phase 2 we will develop a clinical prediction rule to identify people resilient to or at risk for major depression. This phase will focus on the potential impact of the current crisis upon mental health and well being in vulnerable groups, in conjunction with the results of the genotyping analysis. In Phase 3 involves the development of a pilot low-intensity intervention specifically designed to be used in conjunction with the clinical prediction rule, aimed at helping people cope with their illness and the crisis better. The project should identify the most vulnerable to the current crisis patients regarding depression development and demonstrate the beneficial effect of introducing the clinical prediction rule care intervention. The expectation of the research team is that work from this study will inform clinical practice and policy.

Summary of project results

Evidence supporting the association of economic insecurity with psychological distress is strong, as is the evidence supporting the association of economic insecurity with Major Depressive Disorder (MDD) and suicide. No studies, investigated which resilience/risk factors are of particular importance during a financial crisis and whether a biological element acts as moderator in MDD development in high-risk and further studies are needed to investigate these relationships. The project’s objectives achieved, as our project made a number of noteworthy contributions. First, the findings increased our understanding regarding the prevalence of MDD and other mental disorders in the era of the current recession. Second, the findings expanded our knowledge concerning the impact of crisis in the Greek population. Third, we provided three standardized instruments assessing psychological aspects for use within the Greek population. Fourth, we were able to suggest targeted interventions that would promote the development of strategies for MDD prevention in vulnerable people. Key themes that emerged suggested that the main risk factors for MDD in patients with LTCs were the financial crisis, the severity of underlying physical illness, and the patient’s social environment. In summary the results of the present study identified the following risk and protective factors for depression in people with chronic medical illnesses in the era of the current Greek recession: A. Risk factors: Increased worries about the consequences of the medical illness, greater adoption of negative religious coping, a combination of greater perceived impact and major depression significantly increases the suicide risk, a combination of a medical diagnosis with substrate vulnerability in the 5-HTTLPR genotype increases the risk for depression, greater perceived impact of the recession, younger age, lower education received, greater illness concern, pain and fatigue. B. Protective factors: Higher levels of Sense of Coherence, better perception of the identity of the illness, higher levels of resilience as defined in the Resilience scale, greater use of positive religious coping, older age, higher education received, higher beliefs regarding their personal and treatment control over the illness, better comprehension of the illness.

Summary of bilateral results