| One-year postcollaborative depression care trial outcomes among predominantly Hispanic diabetes safety net patients. | |
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MedLine Citation:
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PMID: 21774987 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of this study was to determine sustained effectiveness in reducing depression symptoms and improving depression care 1 year following intervention completion. METHOD: Of 387 low-income, predominantly Hispanic diabetes patients with major depression symptoms randomized to 12-month socioculturally adapted collaborative care (psychotherapy and/or antidepressants, telephone symptom monitoring/relapse prevention) or enhanced usual care, 264 patients completed 2-year follow-up. Depression symptoms (Symptom Checklist-20 [SCL-20], Patient Health Questionnaire-9 [PHQ-9]), treatment receipt, diabetes symptoms and quality of life were assessed 24 months postenrollment using intent-to-treat analyses. RESULTS: At 24 months, more intervention patients received ongoing antidepressant treatment (38% vs. 25%, χ(2)=5.11, df=1, P=.02); sustained depression symptom improvement [SCL-20 <0.5 (adjusted odds ratio=2.06, 95% confidence interval=1.09-3.90, P=.03), SCL-20 score (adjusted mean difference -0.22, P=.001) and PHQ-9 ≥50% reduction (adjusted odds ratio=1.87, 95% confidence interval =1.05-3.32, P=.03)]. Over 2 years, improved effects were found in significant study group by time interaction for Short Form-12 mental health, Sheehan Disability Scale (SDS) functional impairment, diabetes symptoms, anxiety and socioeconomic stressors (P=.02 for SDS; P<.0001 for all others); however, group differences narrowed over time and were no longer significant at 24 months. CONCLUSIONS: Socioculturally tailored collaborative care that included maintenance antidepressant medication, ongoing symptom monitoring and behavioral activation relapse prevention was associated with depression improvement over 24 months for predominantly Hispanic patients in primary safety net care. |
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Authors:
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Kathleen Ell; Wayne Katon; Bin Xie; Pey-Jiuan Lee; Suad Kapetanovic; Jeffrey Guterman; Chih-Ping Chou |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2011-07-19 |
Journal Detail:
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Title: General hospital psychiatry Volume: 33 ISSN: 1873-7714 ISO Abbreviation: Gen Hosp Psychiatry Publication Date: 2011 Sep-Oct |
Date Detail:
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Created Date: 2011-09-16 Completed Date: 2012-02-24 Revised Date: 2012-09-28 |
Medline Journal Info:
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Nlm Unique ID: 7905527 Medline TA: Gen Hosp Psychiatry Country: United States |
Other Details:
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Languages: eng Pagination: 436-42 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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School of Social Work, MRF 102R (MC 0411), University of Southern California, Los Angeles, CA 90089-0411, USA. ell@usc.edu |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00709150 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antidepressive Agents / therapeutic use Cooperative Behavior Cultural Characteristics Depressive Disorder, Major / diagnosis, psychology*, therapy* Diabetes Mellitus / psychology* Female Health Services Accessibility / statistics & numerical data Hispanic Americans / psychology* Humans Intention to Treat Analysis Interdisciplinary Communication Male Middle Aged Patient Satisfaction Poverty Quality of Life Questionnaires Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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R01 MH068468/MH/NIMH NIH HHS; R01 MH068468-04/MH/NIMH NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antidepressive Agents |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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