Table 1.
Materials and methods in the Jorvi bipolar study (JoBS), the Vantaa depression study (VDS), and the Vantaa primary care depression study (PC-VDS).
| JoBS | VDS | PC-VDS | |
|---|---|---|---|
| Sampling period | Jan 1, 2002–Feb 28, 2003 | Feb 1, 1997–May 31, 1998 | Jan 2, 2002–Dec 31, 2002 |
| Setting | Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland (catchment area 261,116 in 2002) | Department of Psychiatry of Peijas Medical Care District, Helsinki University Central Hospital, Vantaa, Finland (catchment area 169,000 in 1997) | Primary Healthcare Organization of the City of Vantaa, Finland Three health centers and two maternity clinics serving two districts in the city of Vantaa on population basis (catchment area 63,400 in 2002). |
| Screening | All psychiatric in- and outpatients aged 18–59 years Seeking treatment Referred to treatment In an acute deteriorating clinical state among patients within secondary care |
All psychiatric in- and outpatients aged 20–59 years Seeking treatment Referred to treatment In an acute deteriorating clinical state among patients within secondary care |
Consecutive primary care patients aged 20–69 years in general practitioners' waiting room on randomly selected days, stratified for day of the week and month, and time of year. |
| Screening procedure | (1) Mood disorders questionnaire, 7/13 items positive, or (2) Clinical suspicion of BD (n = 28) | (1) One of five screening questions for depression from SCAN, or (2) Scale for suicide ideation, score ≥6 |
In two phases: (1) PRIME-MD: a positive item for depressive mood or anhedonia during the last month, and (2) telephone interview: confirmed presence of one main symptom of DSM-IV MDD (according to SCID-I/P) |
| Excluded in screening | ICD-10 schizophrenia | ICD-10 schizophrenia, or BD-I | Current psychiatric secondary care contact, primary psychotic disorder, bipolar and organic mood disorders, alcohol use disorders preventing 2 weeks' abstinence for interview, insufficient communication or Finnish language skills, poor general health status or medical emergency preventing screening |
| Total screened | 1,630 | 806 | 1,119 |
| Screened positive | 546 | 703 | 402 (PRIME-MD), 375 telephone interview |
| Coverage of screening | 46 (2.8%) declined from screening 49 (9.0%) with a positive screen declined from interview 7 not contacted |
161 (22.9%) with a positive screen declined from an interview | 8 declined from PRIME-MD screening 27 (6.7%) declined from telephone interview 10 (2.5%) declined from diagnostic interview |
| Interviewed | 490 (SCID-I/P) | 542 (SCAN) | 175 (SCID-I/P) |
| Inclusion criteria | BD type I or II with a new DSM-IV depressive, manic, hypomanic, mixed, or depressive mixed episode. | DSM-IV MDD with a new depressive episode | DSM-IV MDD, dysthymia, or partial depression (two to four symptoms) with or without history of lifetime MDD |
| Eligible | 201 (10 declined) | 269 | 140 (3 declined) |
| Cohort | 191 (65 inpatients and 126 outpatients) BD I: 90 BD II: 101 Men: 90 Women: 101 Age (mean) at baseline: 37.7 years (SD 12.2) |
269 (46 inpatients, 223 outpatients) Men: 73 Women: 196 Age (mean) at baseline: 39.6 years (SD 11.1) |
137 outpatients from primary care Current MDD: 91 Partial MDD: 46 (includes four patients with dysthymia) Men: 33 Women: 104 Age (mean) at baseline: 45.3 years |
| Patients at 6-month follow-up | 176 (92.1%) | 229 (85.1%) | – |
| Patients at 18-month follow-up | 160 (83.8%) | 207 (76.9%) | 127 (93%) |
| 5-year follow-up | 113 (61.7%) | 182 (67.7%) | 112 (82.0%) |
|
Number of patients Switch of diagnosis Participants vs. non-participants Follow-up time |
1 schizoaffective disorder No difference in prevalence of suicide attempts before or during index episode at baseline. Median 62.2 months |
29 BD, 1 schizophrenia, 2 schizoaffective disorder No difference in prevalence of suicide attempts or suicidal ideation before or during index episode at baseline. Median 62.4 months |
6 BD No difference in age, gender, or baseline depression severity. Median 62.9 months |
| Diagnostic reliability at baseline | 20 random videotaped diagnostic interviews; kappa coefficient for BD = 1.0 | 20 videotaped diagnostic interviews; Kappa coefficient for MDD = 0.86 (95% CI = 0.58–1.00) | 20 random videotaped diagnostic interviews; kappa coefficient for current full and partial MDD = 1.0 |
| Symptom assessment | BAI, BDI, BHS, HAM-D, SSI, YMRS (baseline and at all follow-ups) | BAI, BDI, BHS, HAM-D, SSI (baseline and at all follow-ups), in addition BDI monthly for first 6 months | BAI, BDI, BHS (baseline, 3, 6, and 18 months, and 5 years), and HAM-D, SSI (baseline, 18 months, and 5 years) |
BAI, Beck anxiety inventory; BD, bipolar disorder; BDI, Beck depression inventory; BHS, Beck hopelessness scale; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th edition; HAM-D, Hamilton rating scale for depression; ICD-10, International Classification of Disease, 10th edition; JoBS, Jorvi bipolar study; MDD, major depressive disorder; PC-VDS, Vantaa primary care depression study; PRIME-MD, primary care evaluation of mental disorders; SCAN, schedules for clinical assessment of neuropsychiatry; SCID-I/P, structured clinical interview for DSM-IV disorders; SSI, the scale for suicidal ideation; VDS, Vantaa depression study; YMRS, young mania rating scale.