Improving care for depression in obstetrics and gynecology: a randomized controlled trial.

Abstract:

OBJECTIVE:To evaluate an evidence-based collaborative depression care intervention adapted to obstetrics and gynecology clinics compared with usual care. METHODS:A two-site, randomized controlled trial included screen-positive women (Patient Health Questionnaire-9 score of at least 10) who met criteria for major depression, dysthymia, or both (Mini-International Neuropsychiatric Interview). Women were randomized to 12 months of collaborative depression management or usual care; 6-month, 12-month, and 18-month outcomes were compared. The primary outcomes were change from baseline to 12 months in depression symptoms and functional status. Secondary outcomes included at least 50% decrease and remission in depressive symptoms, global improvement, treatment satisfaction, and quality of care. RESULTS:Participants were, on average, 39 years old, 44% were nonwhite, and 56% had posttraumatic stress disorder. Intervention (n=102) compared with usual care (n=103) patients had greater improvement in depressive symptoms at 12 months (P<.001) and 18 months (P=.004). The intervention group compared with usual care group had improved functioning over the course of 18 months (P<.05), were more likely to have at least 50% decrease in depressive symptoms at 12 months (relative risk [RR] 1.74, 95% confidence interval [CI] 1.11-2.73), greater likelihood of at least four specialty mental health visits (6-month RR 2.70, 95% CI 1.73-4.20; 12-month RR 2.53, 95% CI 1.63-3.94), adequate dose of antidepressant (6-month RR 1.64, 95% CI 1.03-2.60; 12-month RR 1.71, 95% CI 1.08-2.73), and greater satisfaction with care (6-month RR 1.70, 95% CI 1.19-2.44; 12-month RR 2.26, 95% CI 1.52-3.36). CONCLUSION:Collaborative depression care adapted to women's health settings improved depressive and functional outcomes and quality of depression care. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov, www.clinicaltrials.gov, NCT01096316. LEVEL OF EVIDENCE:I.

journal_name

Obstet Gynecol

authors

Melville JL,Reed SD,Russo J,Croicu CA,Ludman E,LaRocco-Cockburn A,Katon W

doi

10.1097/AOG.0000000000000231

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

1237-1246

issue

6

eissn

0029-7844

issn

1873-233X

pii

00006250-201406000-00014

journal_volume

123

pub_type

杂志文章,多中心研究,随机对照试验
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    authors: Comstock C,Huston K,Lee W

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    abstract::Terbutaline was administered to 50 women, all diagnosed as being in labor prior to 36 weeks' gestation. In 47, uterine activity was initially arrested with intravenous therapy. The infusion rate required to arrest uterine activity ranged from 10 to 80 microgram/min and 21 of the 50 patients (42%) required more than on...

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    doi:10.1097/00006250-197804000-00001

    authors: Wallace RL,Caldwell DL,Ansbacher R,Otterson WN

    更新日期:1978-04-01 00:00:00

  • Protein supplementation and the incidence of apoptosis and oxidative stress in mouse embryos.

    abstract:OBJECTIVE:To estimate the effect of protein supplementation of culture media on reactive oxygen species production and incidence of apoptosis in preimplantation mouse embryos. METHODS:A total of 72 two-cell mouse embryos were cultured in human tubal fluid (HTF) alone (HTF-alone, control) and 71 embryos in HTF with pro...

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    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000152384.91385.71

    authors: Esfandiari N,Falcone T,Agarwal A,Attaran M,Nelson DR,Sharma RK

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    abstract::Topical 5-fluorouracil (5-FU) has proven effective in epidermoid cancers of the head and neck. Its effectiveness has been correlated with the ability of the patient's immunologic system to recognize new antigens. In this study, 8 patients with carcinoma in situ of the vulva were evaluated and treated with topical 5-FU...

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    doi:

    authors: Krupp PJ,Bohm JW

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  • Discrepancy in the interpretation of cervical histology by gynecologic pathologists.

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    更新日期:2002-08-01 00:00:00

  • Identification of fetal growth retardation: comparison of Doppler waveform indices and serial ultrasound measurements of abdominal circumference and fetal weight.

    abstract:OBJECTIVE:To compare the serial ultrasound assessment of abdominal circumference (AC) and fetal weight versus single values of umbilical artery pulsatility index (PI) and the aortic-middle cerebral PI ratio in the identification of fetal growth retardation (FGR). METHODS:Serial AC measurements and estimates of weight ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Chang TC,Robson SC,Spencer JA,Gallivan S

    更新日期:1993-08-01 00:00:00

  • Incidence and risk factors for stroke in pregnancy and the puerperium.

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    doi:10.1016/s0029-7844(00)00880-2

    authors: Silberstein SD,Massiou H,Le Jeunne C,Johnson-Pratt L,McCarroll KA,Lines CR

    更新日期:2000-08-01 00:00:00

  • The prognostic value of antinuclear antibodies in women with recurrent pregnancy losses: a prospective controlled study.

    abstract::Because autoimmune diseases are suspected of causing some cases of recurrent pregnancy loss, we sought clinical and serologic evidence of such diseases in a group of 277 women with recurrent pregnancy loss. Using HEp-2 cells as targets for an indirect immunofluorescence test for antinuclear antibodies, we compared the...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Harger JH,Rabin BS,Marchese SG

    更新日期:1989-03-01 00:00:00

  • Bilateral tubal pregnancy with vaginal delivery.

    abstract::A 26-year-old woman was admitted with a diagnosis of septic incomplete abortion. Subsequently she was discovered to have bilateral tubal ectopic pregnancies. The right tube was not badly damaged. Its contents were removed by linear salpingotomy and the tube was repaired. Fifteen months later the patient delivered a li...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Foster HM,Lakshin AS,Taylor WF

    更新日期:1982-11-01 00:00:00

  • Committee Opinion No 708: Improving Awareness of and Screening for Health Risks Among Sex Workers.

    abstract::The population of women who sell or exchange sex or intimate sexual services for material goods or services, also called "sex work," often is unrecognized in the typical obstetric and gynecologic practice. The prevalence of this behavior among adult women is difficult to quantify because of its frequent omission from ...

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    pub_type: 杂志文章,实务指引

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    authors:

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(99)00294-x

    authors: Ohno Y,Kawai M,Wakahara Y,Kitagawa T,Kakihara M,Arii Y

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  • Adenocarcinoma of the vagina in a patient with gonadal dysgenesis.

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    doi:

    authors: Shingleton HM,Younger JB,Beasley WE,Levy D,Gore H,Lawrence WD

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  • The effect of magnesium sulfate on fetal heart rate baseline variability.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Babaknia A,Niebyl JR

    更新日期:1978-01-01 00:00:00

  • Risk factors associated with presenting for abortion in the second trimester.

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    更新日期:2006-01-01 00:00:00

  • Inadvertent administration of prostaglandin E1 instead of prostaglandin F2 alpha in a patient with uterine atony and hemorrhage.

    abstract::A woman underwent cesarean delivery for premature labor, breech presentation, and ruptured membranes. Placenta accreta associated with uterine atony and severe hemorrhage was diagnosed. Prostaglandin E1 instead of prostaglandin F2 alpha was inadvertently administered in an effort to control the hemorrhage. The resulti...

    journal_title:Obstetrics and gynecology

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    doi:

    authors: Reedy MB,McMillion JS,Engvall WR,Sulak PJ,Fisher NL

    更新日期:1992-05-01 00:00:00

  • Early placenta previa and delivery outcome.

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    doi:

    authors: Comeau J,Shaw L,Marcell CC,Lavery JP

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  • What Is New in Recurrent Pregnancy Loss?: Best Articles From the Past Year.

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    journal_title:Obstetrics and gynecology

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  • Hysteroscopic resection of intrauterine scars using a new technique.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Neuwirth RS,Hussein AR,Schiffman BM,Amin HK

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  • Ectopic pregnancy: changes in serum human chorionic gonadotropin concentration.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Cartwright PS,DiPietro DL

    更新日期:1984-01-01 00:00:00

  • Retained viable single intrauterine pregnancy after vacuum aspiration for a dichorionic-diamniotic twin pregnancy.

    abstract:BACKGROUND:Retained viable intrauterine pregnancy is an infrequent complication of vacuum aspiration. We report a case of a retained single intrauterine pregnancy after an elective vacuum aspiration of a dichorionic-diamniotic twin gestation. CASE:A patient presented to the emergency department reporting vaginal spott...

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Porter KB,O'Brien WF,Towsley G,Cates JD,Watts DB

    更新日期:1993-05-01 00:00:00

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:

    authors: Richards DS,Seeds JW,Katz VL,Lingley LH,Albright SG,Cefalo RC

    更新日期:1988-09-01 00:00:00

  • Ulipristal Acetate for Treatment of Uterine Leiomyomas: A Randomized Controlled Trial.

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    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究,随机对照试验

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    doi:

    authors: Hreshchyshyn MM,Hopkins A,Zylstra S,Anbar M

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    doi:

    authors: Meldrum DR

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  • Operative Vaginal Birth: ACOG Practice Bulletin Summary, Number 219.

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    pub_type: 杂志文章,实务指引

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    authors: Faustin D,Minkoff H,Schaffer R,Crombleholme W,Schwarz R

    更新日期:1985-08-01 00:00:00