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Improving depression treatment for women: integrating a collaborative care depression intervention into OB-GYN care.

Abstract：

BACKGROUND:Women have higher rates of depression and often experience depression symptoms during critical reproductive periods, including adolescence, pregnancy, postpartum, and menopause. Collaborative care intervention models for mood disorders in patients receiving care in an OB-GYN clinic setting have not been evaluated. Study design and methodology for a randomized controlled trial of collaborative care depression management versus usual care in OB-GYN clinics and the details of the adapted collaborative care intervention and model implementation are described in this paper. METHODS:Women over age 18 years with clinically significant symptoms of depression, as measured by a Patient Health Questionnaire-9 (PHQ-9) score ≥10 and a clinical diagnosis of major depression or dysthymia, were randomized to the study intervention or to usual care and were followed for 18 months. The primary outcome assessed was change over time in the SCL-20 depression scale between baseline and 12 months. BASELINE RESULTS:Two hundred five women were randomized: 57% white, 20% African American, 9% Asian or Pacific Islander, 7% Hispanic, and 6% Native American. Mean age was 39 years. 4.6% were pregnant and 7.5% were within 12 months postpartum. The majority were single (52%), and 95% had at least the equivalent of a high school diploma. Almost all patients met DSM IV criteria for major depression (99%) and approximately 33% met criteria for dysthymia. CONCLUSIONS:An OB-GYN collaborative care team, including a social worker, a psychiatrist, and an OB-GYN physician, who met weekly and used an electronic tracking system for patients was the essential element of the proposed depression care treatment model described here. Further study of models that improve quality of depression care that are adapted to the unique OB-GYN setting is needed.

journal_name

Contemp Clin Trials

journal_title

Contemporary clinical trials

authors

LaRocco-Cockburn A,Reed SD,Melville J,Croicu C,Russo JE,Inspektor M,Edmondson E,Katon W

doi

10.1016/j.cct.2013.08.001

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

362-70

issue

eissn

1551-7144

issn

1559-2030

pii

S1551-7144(13)00125-0

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Improving depression treatment for women: integrating a collaborative care depression intervention into OB-GYN care.