On Wednesday 13th of May, Eline Eigenhuis will defend her PhD thesis titled ‘Improving accessibility and outcome of treatment for depression and anxiety’ in the Auditorium of the Vrije Universiteit Amsterdam at 11:45.
In this thesis Eline Eigenhuis has investigated how to improve accessibility and outcomes for individuals with common mental disorders by examining factors that influence help seeking, treatment engagement, vulnerability, and responsiveness to innovative interventions. Together, the findings of these studies underscore the importance of early engagement, personalised care, and interventions that address vulnerabilities in order to improve the prognosis of common mental disorders.
The first study identifies key barriers and facilitators of help seeking among adolescents and young adults with depressive symptoms, highlighting the roles of mental health literacy, personal attitudes, social context, and service accessibility. Study number 2 was a meta-analysis on the effect of patient treatment preferences on clinical outcome, satisfaction and adherence. The third study demonstrates that subthreshold borderline personality disorder symptoms increase the likelihood of both first onset and recurrence of major depressive disorder, indicating that even mild personality features contribute to vulnerability. The final studies evaluate two interventions that target underlying risk factors: Memory Specificity Training and Group schema therapy.
“This thesis is my attempt to improve access to care and outcomes for patients with depression and anxiety.” – Eline Eigenhuis
Findings
Eline’s research shows that depression and anxiety can be better prevented and treated in early intervention and tailored care to what people actually need. Youths seek help late due to shame, lack of mental health knowledge, stigma, and long waiting times. But school staff, peers, and parents recognising symptoms, plus direct access to care, are powerful facilitators. Once in treatment, accommodating patient preferences (like therapy vs. medication) doesn’t improve symptoms significantly but boosts satisfaction and adherence substantially. Even mild borderline personality traits increase depression risk and risk of recurrence. Innovative treatments work. Memory Specificity Training is feasible for depressed outpatients (improving memory specificity and depressive symptoms), while group Schema Therapy shows promise for treatment non-responders with persistent anxiety, depression, or psychosomatic complaints.
Prevention is crucial
Improving prognosis requires a focus on prevention, early access to care, and tailoring treatment to individual preferences and vulnerabilities. Early identification of risk factors, such as personality traits and emerging psychological symptoms, might help prevent worsening and improve outcomes in anxiety and depression. Increasing knowledge and awareness through campaigns in schools, universities, and workplaces can reduce stigma. And it could encourage timely help-seeking, while also highlighting the role of peers and family in recognising symptoms. Shared decision-making is essential, as aligning treatment with patient preferences enhances adherence, satisfaction, and the likelihood of seeking help again in the future despite high relapse rates. Additionally, understanding the underlying causes and recurrence of mental health problems (through approaches like case conceptualisation and addressing maladaptive personality traits) may improve treatment effectiveness. This is true particularly for individuals who do not respond sufficiently to standard guideline-based care. Although further research is needed before widespread implementation.
On Wednesday 13th of May, Eline Eigenhuis will defend her PhD thesis titled ‘Improving accessibility and outcome of treatment for depression and anxiety’ in the Auditorium of the Vrije Universiteit Amsterdam at 11:45. Eline’s thesis is supervised by Prof. Dr. Patricia van Oppen and Prof. Dr. Neeltje Batelaan, and co-supervised by Dr. Rosa Boeschoten and Dr. Anna Muntingh. More information on this dissertation can be found on the website of VU Amsterdam.
Eline Eigenhuis is a clinical psychologist and researcher at GGZ inGeest and department of Psychiatry Amsterdam UMC. “My motivation for this research stems from clinical practice. Why do people seek help so late? Why do treatments fail for some patients? (…) This thesis is my attempt to improve access to care and outcomes for patients with depression and anxiety.”
