Das "Nürnberger Bündnis gegen Depression"

Background: Recent studies showed the increasing importance of
depressive disorders. Despite good treatment possibilities
(pharmacological treatment and psychotherapy) only a minority of
patients receive adequate treatment. One of the most dramatic
consequences is a big number of suicides. Methods: Within the
competence network on depression and suicidality (founded by the
German Ministry for Education and Research) a multi-level program
was carried out in 2001 and 2002: the “Nuremberg Alliance against
Depression”. In the centre of the activities was the optimisation
of diagnosis and therapy in primary care. Family doctors received
continuous education and different screening tools were
established. Brochures and videos were produced to improve
patients` knowledge of symptoms, causes and treatment
possibilities. Besides that an intense information campaign was
started (posters, lectures, cinema spot, leaflets etc.). Moreover a
close cooperation with other community facilitators (priests,
geriatric nurses, teachers etc.) should improve awareness towards
depression and suicidality. Finally, special support for patients
and their relatives was provided. A telephone hotline for persons
after suicide attempt offered help in the case of a further
suicidal crisis. Main outcome criteria of the study was the
reduction of suicidal acts (suicides and suicide attempts) in
comparison to a baseline-year (2000) and a control region
(Wuerzburg). Results: The results for the first year of
intervention (2001) show a significant decrease of suicidal acts in
Nuremberg compared to the baseline and to the control region.
Suicidal acts dropped from 620 cases to 500 cases (p=0.046). The
decrease of persons committing a suicide attempt was 21.6% (375 vs.
475 cases) and differed significantly from the control region
(p=0.008). Completed suicides decreased from 100 to 75 (-25%) which
was not significant compared to the control region where a similar
reduction in suicide rates was observed.