Stiftung Deutsche Depressionshilfe
Konto: 3474200
BLZ: 86020500
IBAN: DE73860205000003474200 SWIFT / BIC: BFSWDE33LPZ
Bank für Sozialwirtschaft

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English (General Information)

General information about the German Research Network on Depression and Suicidality

1. Network Profile

The German Research Network on Depression and Suicidality is one of currently 17  Research Networks in Medicine funded by the German Ministry for Research and Education.
In order to address the multiple deficits with regard to diagnosis, treatment and research in the field of depressive disorders the Research Network connects 15 German research centres and university hospitals as well as the most important institutions in the German health care system (e.g. health insurance funds and associations of consultant practitioners). In co-operation with those network partners six main projects are realized. Each project consists of several subprojects.
The concept received positive reviews by an international jury in 1999 and was one of the winners out of totally 160 applications. The German government supported the Network with more than 13 million Euros over  the first five years from 1999 to 2004. The last period of funding lasts from 2005 probably until 2008. The Network will be supported within this time by 500.000 Euros every year.

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2. Thematic Range of the Network Research

  • Project 1: Prevention and Neurobiology of Suicidality

    The project's main focus is the implementation and evaluation of suicide preventive measures. Subproject 1.1 is modelled on the "Gotland study" and carries forward the Gotland activities  to Nuremberg by implementing an intensive awareness programme on depression and suicidality  (‘Nürnberger Bündnis gegen Depression’ = ‘Nuremberg Alliance against Depression’, information available in German). Many suicide preventive  measures on different action levels are part of the project. By combining cooperation and training of GPs and other professionals such as teachers, priests, and employees in geriatric care with public relations efforts, e.g. posters, informative cinema ads,  etc., the project tries to achieve its goals. These activities are evaluated by comparing the number of suicides and suicide attempts to a one-year baseline and to another city where no such project is performed.

    After two successful years of the Nuremberg campaign, the ‘German Alliance against Depression’ is now expanding to other towns and regions in Germany (service and information available in German). Since April 2004 the project takes place Europewide, too. Funded by the European Commission the “European Alliance Against Depression” is implementing programs and materials based on the Nuremberg experiences in 16 countries.

    Another subproject tries for the first time to prove the postulated suicide prevention effect of an early lithium medication within a prospective study. Other subprojects deal with biological aspects of suicidality.

  • Project 2: Treatment of Minor and Subthreshold Depression

    A 5-armed study examines the efficacy of cognitive behavioural therapy and antidepressant medication compared to placebo medication or unspecific supportive group treatment for patients with minor and subthreshold depressive disorders. The fifth arm includes patients who are free to choose between treatment with an antidepressant or cognitive behavioural therapy.
    The study is innovative and relevant for health care because of several aspects: Patients with minor depressive disorders, with and without co-morbid anxiety symptoms or somatic disorders are included. These patients are often seen in primary care settings, but have only rarely been investigated.

    A combined study of pharmacotherapy and psychotherapy is important for a rational use of resources. Due to the increasing number of psychotherapeutically working colleagues in Germany (as a consequence of the new German psychotherapist law) this is a particularly urgent question.

    The free choice therapy arm enables the network to examine the interaction between the patients’ therapy  expectations or disease model on the one side and the offered therapy on the other. If such effects prove to be very important, they have to be taken into consideration for therapy planning in daily practice. Other subprojects focus on the prevention of chronification in persons suffering from depression and somatic disorders.

  • Project 3: Quality Management of Depression Treatment

    Several subprojects intend to improve and to evaluate health care quality. The measures range from the development of guidelines and training material, the establishment and evaluation of quality management in the outpatient and inpatient field to the evaluation of therapeutic drug monitoring. By integrating all important partners of the health care system, a broad of the guidelines and material shall be achieved. A long-term improvement of care quality shall be achieved by measures like development and establishment of a quality oriented payment system. Project 3 is based on the other projects' results. 

  • Project 4: Mode of Action in Antidepressant Therapies

    By a set of complementary subprojects on biological mode of action in antidepressant treatments, new points of intervention and a more accurate use of these treatments shall be achieved. Among other things molecular biological methods are used. Subject is for example the activation of signal-transduction ways by different antidepressant therapies or the causal role of a disturbed stress hormone regulation in depression genesis. 

  • Project 5: Molecular Genetics / Pharmacogenetics

    Project 5 searches for possible genes responsible for vulnerability that a) influence the development of the disorder and b) the response to treatment on a pharmacokinetic and pharmacodynamic level. A network of different centers is the precondition of recruiting and examining a sufficient number of families and patients with standardized instruments, which is necessary for molecular genetic and pharmacogenetic studies.

  • Project 6: Therapy Non-Response, Chronicity and their Prediction in Major Depressive Disorders

    This project is divided in several sub-projects. The center of this project is a 4-Year Follow-Up-Study on inpatients with major depressive disorders receiving naturalistic treatment. The patient assessment considers psychopathological, psychosocial as well as biological factors. Major aims are the evaluation of the complex conditions leading to therapy non-response and chronicity in major depression and to identify those factors which can predict aspects of outcome. Apart from that, the project also includes several intervention studies which follow the aim to improve the acute treatment response as well as the prevention of further relapses of the illness.

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3. International Activities

From the “Nuremberg Alliance Against Depression” (Project 1) developed the “European Alliance Against Depression”, funded by the European Commission.
The speaker and members of the Network present findings at international conferences.

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4. Research and Development

In recent years several important epidemiological and health-economic studies conducted on a national and global level have underlined that depressive disorders have a great impact on public health in developed countries. The results prompted the World Health Organisation (WHO) to call for national programmes to improve medical care. The studies also suggested a need for optimisation in certain fields of therapy and current deficits in research. The German Research Network on Depression addresses the multiple deficits with regard to diagnosis, treatment and research.

Improvement of diagnosis
The most effective approach for diagnostic improvement arises from a close co-operation with general practitioners.

Improvement of therapy
Nowadays approximately 70-80 percent of depressive diseases can be treated successfully. Programmes are required which help to establish efficient treatment at the level of general practitioners.

Improvement of research
Important research questions arising from the work of general practitioners are taken into consideration, e.g. research in the field of minor and subthreshold depressive disorders. Other research questions deal with the treatment of chronic and therapy resistant severe depressions and the clarification of the pathogenesis of depression and suicidality.

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5. Relevance for the German Health Care System

The importance of depressive disorders can be attributed to their frequency. Depressive disorders are by far the most frequent psychiatric disorders in the population. About 4 Million people in Germany suffer from depression. It is the aim of the Network to improve the therapy of depression. In addition to the personal suffering caused by the disorder, depression is also responsible for the highest health costs of all mental disorders. Therefore the German health care system will also benefit from research findings by the Network that lead to earlier diagnosis and efficient therapy.

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6. Training offers

The Network offers extensive and important information on depressive disorders to professionals as well as patients via the Internet. Several subprojects offer special training courses on depression for general practitioners and multipliers.

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