A Randomized Controlled Trial of a Close Monitoring Program for Minor Depression and Distress
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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.
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.
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.
Overall, 223 PC subjects with minor depression or distress consented to participation in this trial.
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.
Subjects in the CM arm exhibited fewer psychiatric diagnoses than those in the UC arm (χ2 = 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) (χ2 = 5.90, 1 df, p = .02).
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.
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- A Randomized Controlled Trial of a Close Monitoring Program for Minor Depression and Distress
Journal of General Internal Medicine
Volume 23, Issue 9 , pp 1379-1385
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- minor depression
- close monitoring
- telephone care management
- Industry Sectors
- Author Affiliations
- 1. Philadelphia Veterans Affairs Medical Center and the VISN 4 Mental Illness Research, Education, and Clinical Center (MIRECC), Philadelphia, PA, USA
- 3. Section of Geriatric Psychiatry, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- 4. Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- 2. Philadelphia VA Center of Excellence in Substance Abuse Treatment and Education (CESATE), Philadelphia, PA, USA
- 5. Center for the Study of Addictions, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA