ODIN - Outcome of Depression International Network study


About the ODIN study

Objectives:

To determine the acceptability of two psychological interventions for depressed adults in the community and their effect on caseness, symptoms, and subjective function.

Design:

A pragmatic multicentre randomised controlled trial, stratified by centre.

Setting:

Nine urban and rural communities in Finland, Republic of Ireland, Norway, Spain, and the United Kingdom.

Participants:

452 participants aged 18 to 65, identified through a community survey with depressive or adjustment disorders according to the international classification of diseases, 10th revision or Diagnostic and Statistical Manual of Mental Disorders, fourth edition.

Interventions:

Six individual sessions of problem solving treatment (n = 128), eight group sessions of the course on prevention of depression (n = 108), and controls (n = 189).

Main outcome measures:

Completion rates for each intervention, diagnosis of depression, and depressive symptoms and subjective function.

Results:

63% of participants assigned to problem solving and 44% assigned to prevention of depression completed their intervention. The proportion of problem solving participants depressed at six months was 17% less than that for controls, giving a number needed to treat of 6; the mean difference in Beck depression inventory score was -2.63 (95% confidence interval -4.95 to -0.32), and there were significant improvements in SF¬36 scores. For depression prevention, the difference in proportions of depressed participants was 14% (number needed to treat of 7); the mean difference in Beck depression inventory score was -1.50 (-4.16 to 1.17), and there were significant improvements in SF¬36 scores. Such differences were not observed at 12 months. Neither specific diagnosis nor treatment with antidepressants affected outcome.

Conclusions:

When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression. Both interventions reduced caseness and improved subjective function.

Publications

Dowrick, C.F., Dunn, G. Ajuso-Mateos, J.-L., Dalgard, O.S., Page, H., Lehtinen, V., Casey, P., Wilkinson, C., Vázquez-Barquero, J.-L., Wilkinson, G. & the ODIN Group (2000). Problem-solving treatment and group psycho-education for depression: a multicentre randomized controlled trial. British Medical Journal 321, 1450-1454. - PDF (251 kb)
Notes: original analysis based on intention to treat. Missing data allowed for by use of inverse probability weights based on observed compliance patterns and other covariates.

Ajuso-Mateos, J.L., Vázquez-Barquero, J.-L., Dowrick, C., Lehtinen, V., Dalgard, O.S., Casey, P., Wilkinson, C., Lasa, L., Page, H., Dunn, G., Wilkinson, G. & the ODIN Group (2001). Depressive disorders in Europe: morbidity figures from the ODIN study. British Journal of Psychiatry 179, 308-316.

Dowrick, C., Ajuso-Mateos, J. L., Vázquez-Barquero, J.-L., Dunn, G., Dalgard, O.S., Lehtinen, V., Casey, P., Wilkinson, C., Page, H., Lasa, L., Michalak, E., Wilkinson, G. and the ODIN Group (2002). From epidemiology to intervention for depressive disorders in the general population. World Psychiatry 1:3, 169-174.

Dunn, G. Maracy, M., Dowrick, C., Ajuso-Mateos, J.L., Dalgard, O.S., Page, H., Lehtinen, V., Casey, P. Wilkinson, C., Vázquez-Barquero, J.L. Wilkinson, G., and The Outcomes of Depression International (ODIN) Group (2003). Estimating psychological treatment effects from an RCT with both non-compliance and loss to follow-up. British Journal of Psychiatry 183, 323-331. - PDF (203 kb)
Notes: CACE estimation using ML in Mplus, assuming missing data mechanism ignorable. Mplus Version 2.2 used for the analyses in this paper.

Dunn, G., Maracy, M. & Tomenson, B. (2005). Estimating treatment effects from randomized clinical trials with non-compliance and loss to follow-up: the role of instrumental variable methods. Statistical Methods in Medical Research 14, 369-395.
Notes: CACE estimation using ML in Mplus, assuming missing data mechanism ignorable (MAR) or latently ignorable (LI). Sensitivity to exclusion restrictions tested. Other analyses also reported. Mplus Version 3.0 used for the analyses. Standard errors for MAR models different to those produced by Version 2.2, apparently because later version used observed information rather than expected information.

Ayuso-Mateos, J.L., Pereda, A., Dunn, G., Vázquez-Barquero, J.L., Casey, P., Lehtinen, V., Dalgard, O., Wilkinson, G. & Dowrick, C. (2007). Predictors of compliance with psychological interventions offered in the community. Psychological Medicine 37, 717-725.

Maracy, M. & Dunn, G. (2011). Estimating 'Dose-Response' Effects in Psychological Treatment Trials: The Role of Instrumental Variables. Statistical Methods in Medical Research 20(3), 191-215.

ODIN data and example software codes

Please follow this link to download a .zip file containing the ODIN data and example software code for Mplus and Stata.

Once you have downloaded the .zip file, please open the text file "Read Me First.txt" for information about the other documents.