BACKGROUND: Minor depression is almost twice as common in primary care (PC) as major depression. Despite the high prevalence, few evidence-based algorithms exist for managing patients with minor depression or patients presenting solely with distress. OBJECTIVES: The aim of this study was to test the effectiveness of a telephone-based close monitoring program to manage PC patients with minor depression or distress. DESIGN: Subjects were randomly assigned to either the control arm (usual care; UC) or the intervention arm (close monitoring; CM). We hypothesized that those randomized to CM would exhibit less depression and be less likely to have symptoms progress to the point of meeting diagnostic criteria. SUBJECTS: Overall, 223 PC subjects with minor depression or distress consented to participation in this trial. MEASUREMENTS: At baseline, subjects completed a telephone-based evaluation comprised of validated diagnostic assessments of depression and other MH disorders. Outcomes were assessed at six months utilizing this same battery. Chart reviews were conducted to track care received, such as prescribed antidepressants and MH and primary care visits. RESULTS: Subjects in the CM arm exhibited fewer psychiatric diagnoses than those in the UC arm (chi(2) = 4.04, 1 df, p = 0.04). In addition, the intervention group showed improved overall physical health (SF-12 PCS scores) (M = 45.1, SD = 11.8 versus M = 41.5, SD = 12.4) (chi(2) = 5.90, 1 df, p = .02). CONCLUSIONS: Those randomized to CM exhibited less MH problems at the conclusion of the trial, indicating that the close monitoring program is effective, feasible and valuable. The findings of this study will allow us to enhance clinical care and support the integration of mental health services and primary care.
RCT Entities:
BACKGROUND:Minor depression is almost twice as common in primary care (PC) as major depression. Despite the high prevalence, few evidence-based algorithms exist for managing patients with minor depression or patients presenting solely with distress. OBJECTIVES: The aim of this study was to test the effectiveness of a telephone-based close monitoring program to manage PC patients with minor depression or distress. DESIGN: Subjects were randomly assigned to either the control arm (usual care; UC) or the intervention arm (close monitoring; CM). We hypothesized that those randomized to CM would exhibit less depression and be less likely to have symptoms progress to the point of meeting diagnostic criteria. SUBJECTS: Overall, 223 PC subjects with minor depression or distress consented to participation in this trial. MEASUREMENTS: At baseline, subjects completed a telephone-based evaluation comprised of validated diagnostic assessments of depression and other MH disorders. Outcomes were assessed at six months utilizing this same battery. Chart reviews were conducted to track care received, such as prescribed antidepressants and MH and primary care visits. RESULTS: Subjects in the CM arm exhibited fewer psychiatric diagnoses than those in the UC arm (chi(2) = 4.04, 1 df, p = 0.04). In addition, the intervention group showed improved overall physical health (SF-12 PCS scores) (M = 45.1, SD = 11.8 versus M = 41.5, SD = 12.4) (chi(2) = 5.90, 1 df, p = .02). CONCLUSIONS: Those randomized to CM exhibited less MH problems at the conclusion of the trial, indicating that the close monitoring program is effective, feasible and valuable. The findings of this study will allow us to enhance clinical care and support the integration of mental health services and primary care.
Authors: Mohit P Chopra; Cynthia Zubritsky; Kathryn Knott; Thomas Ten Have; Trevor Hadley; James C Coyne; David W Oslin Journal: Am J Geriatr Psychiatry Date: 2005-07 Impact factor: 4.105
Authors: Wayne Katon; Joan Russo; Ellen Frank; James Barrett; John W Williams; Thomas Oxman; Mark Sullivan; John Cornell Journal: Gen Hosp Psychiatry Date: 2002 Jan-Feb Impact factor: 3.238
Authors: Bradford L Felker; Edmund Chaney; Lisa V Rubenstein; Laura M Bonner; Elizabeth M Yano; Louise E Parker; Linda L M Worley; Scott E Sherman; Scott Ober Journal: Prim Care Companion J Clin Psychiatry Date: 2006
Authors: D V Sheehan; Y Lecrubier; K H Sheehan; P Amorim; J Janavs; E Weiller; T Hergueta; R Baker; G C Dunbar Journal: J Clin Psychiatry Date: 1998 Impact factor: 4.384
Authors: Martha L Bruce; Thomas R Ten Have; Charles F Reynolds; Ira I Katz; Herbert C Schulberg; Benoit H Mulsant; Gregory K Brown; Gail J McAvay; Jane L Pearson; George S Alexopoulos Journal: JAMA Date: 2004-03-03 Impact factor: 56.272
Authors: Gregory P Beehler; Jennifer S Funderburk; Paul R King; Kyle Possemato; John A Maddoux; Wade R Goldstein; Michael Wade Journal: J Clin Psychol Med Settings Date: 2020-03
Authors: J Kasckow; J Klaus; J Morse; D Oslin; J Luther; L Fox; C Reynolds; G L Haas Journal: Int J Geriatr Psychiatry Date: 2014-05-01 Impact factor: 3.485
Authors: John Kasckow; Erin Ingram; Charlotte Brown; James D Tew; Kyaien O Conner; Jennifer Q Morse; Gretchen L Haas; Charles F Reynolds; David W Oslin Journal: Psychiatr Serv Date: 2011-04 Impact factor: 3.084
Authors: John Kasckow; Jennifer Morse; Amy Begley; Stewart Anderson; Salem Bensasi; Stephen Thomas; Sandra C Quinn; Charles F Reynolds Journal: Psychiatry Res Date: 2014-06-28 Impact factor: 3.222
Authors: Christopher J Miller; Andrew Grogan-Kaylor; Brian E Perron; Amy M Kilbourne; Emily Woltmann; Mark S Bauer Journal: Med Care Date: 2013-10 Impact factor: 2.983