Jessica Y Breland1, Joseph Mignogna2, Lea Kiefer3, Laura Marsh4. 1. Center for Innovation to Implementation, VA Palo Alto Healthcare System, 795 Willow Road (152-MPD), Menlo Park, CA 94025; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94304. Electronic address: breland@stanford.edu. 2. Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030; Baylor College of Medicine, One Baylor Plaza, BCM 350, Houston, TX 77030; Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center (a virtual center); Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX; Central Texas VA Health Care System, Waco, TX. Electronic address: joseph.mignogna@va.gov. 3. Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX 77030; Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center (a virtual center). Electronic address: lea.kiefer@va.gov. 4. Mental Health Care Line, Michael E, DeBakey VA Medical Center (MEDVAMC 116), 2002 Holcombe Blvd., Houston, TX 77030; Baylor College of Medicine, One Baylor Plaza, BCM 350, Houston, TX 77030; Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center (a virtual center). Electronic address: laura.marsh2@va.gov.
Abstract
OBJECTIVE: This review answered two questions: (a) what types of specialty medical settings are implementing models for treating depression, and (b) do models for treating depression in specialty medical settings effectively treat depression symptoms? METHOD: We searched Medline/Pubmed to identify articles, published between January 1990 and May 2013, reporting on models for treating depression in specialty medical settings. Included studies had to have adult participants with comorbid medical conditions recruited from outpatient, nonstandard primary care settings. Studies also had to report specific, validated depression measures. RESULTS: Search methods identified nine studies (six randomized controlled trials, one nonrandomized controlled trial and two uncontrolled trials), all representing integrated care for depression, in three specialty settings (oncology, infectious disease, neurology). Most studies (N=7) reported greater reductions in depression among patients receiving integrated care compared to usual care, particularly in oncology clinics. CONCLUSIONS: Integrated care for depression in specialty medical settings can improve depression outcomes. Additional research is needed to understand the effectiveness of incorporating behavioral and/or psychological treatments into existing methods. When developing or selecting a model for treating depression in specialty medical settings, clinicians and researchers will benefit from choosing specific components and measures most relevant to their target populations. Published by Elsevier Inc.
OBJECTIVE: This review answered two questions: (a) what types of specialty medical settings are implementing models for treating depression, and (b) do models for treating depression in specialty medical settings effectively treat depression symptoms? METHOD: We searched Medline/Pubmed to identify articles, published between January 1990 and May 2013, reporting on models for treating depression in specialty medical settings. Included studies had to have adult participants with comorbid medical conditions recruited from outpatient, nonstandard primary care settings. Studies also had to report specific, validated depression measures. RESULTS: Search methods identified nine studies (six randomized controlled trials, one nonrandomized controlled trial and two uncontrolled trials), all representing integrated care for depression, in three specialty settings (oncology, infectious disease, neurology). Most studies (N=7) reported greater reductions in depression among patients receiving integrated care compared to usual care, particularly in oncology clinics. CONCLUSIONS: Integrated care for depression in specialty medical settings can improve depression outcomes. Additional research is needed to understand the effectiveness of incorporating behavioral and/or psychological treatments into existing methods. When developing or selecting a model for treating depression in specialty medical settings, clinicians and researchers will benefit from choosing specific components and measures most relevant to their target populations. Published by Elsevier Inc.
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