Randomized Trial of a Depression Management Program in High Utilizers of Medical Care
Archives of Family MedicinePublished 1 April 2000
David J. Katzelnick
Citations333
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
In depressed high utilizers not already in active treatment, a systematic primary care-based treatment program can substantially increase adequate antidepressant treatment, decrease depression severity, and improve general health status compared with usual care.
Abstract
In depressed high utilizers not already in active treatment, a systematic primary care-based treatment program can substantially increase adequate antidepressant treatment, decrease depression severity, and improve general health status compared with usual care.
Keywords
PsychologyMedicine
Journal of Neurology Neurosurgery & PsychiatryA RATING SCALE FOR DEPRESSION
32,633 Citations1960M. Hamilton
The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type, used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information.
Archives of General PsychiatryNational Institute of Mental Health Treatment of Depression Collaborative Research Program
2,324 Citations1989Irene Elkin
There was limited evidence of the specific effectiveness of interpersonal psychotherapy and none for cognitive behavior therapy, but Superior recovery rates were found for both interpersonal Psychotherapy and imipramine plusclinical management, as compared with placebo plus clinical management.
JAMAUtility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study
2,324 Citations1994Robert L. Spitzer
New England Journal of MedicineAn Assessment of Clinically Useful Measures of the Consequences of Treatment
1,676 Citations1988Andreas Laupacis, David L. Sackett +1 more
The goal is to provide a clear picture of the individual components of the immune system and provide a strategy for individualized treatment of these components according to their Kesslerian importance.
JAMACollaborative Management to Achieve Treatment Guidelines
1,395 Citations1995Wayne Katon
A multifaceted intervention consisting of collaborative management by the primary care physician and a consulting psychiatrist, intensive patient education, and surveillance of continued refills of antidepressant medication improved adherence to antidepressant regimens in patients with major and with minor depression and resulted in more favorable depressive outcomes.
Archives of General PsychiatryA Multifaceted Intervention to Improve Treatment of Depression in Primary Care
850 Citations1996Wayne Katon
JAMADepressive Symptoms and the Cost of Health Services in HMO Patients Aged 65 Years and Older
702 Citations1997Jürgen Unützer
Depressive symptoms in older adults are associated with a significant increase in the cost of medical services, even after adjusting for the severity of chronic medical illness.
Medical Entomology and ZoologyMental illness in general health care : an international study
613 Citations1995T. B. Üstün, Norman Sartorius
Partial table of contents: The Background and Rationale of the WHO Collaborative Sudy on 'Psychological Problems in General Health Care' (T. ?st?n & N. Sartiorius), form and Frequency of Mental Disorders Across Centres (D. Goldberg & Y. Lecrubier). Index.
American Journal of PsychiatryHealth care costs associated with depressive and anxiety disorders in primary care
560 Citations1995Gregory E. Simon, Johan Ormel +2 more
In this small sample, improvement in depression over 1 year was not clearly associated with decreases in cost and longitudinal analyses did not show any clear relationship between change in psychiatric diagnosis and change in health care cost.
PubMedConjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice.
553 Citations1995Richard L. Brown, Laura A. Rounds
The CAGE Adapted to Include Drugs (CAGE-AID) was more sensitive but less specific for substance abuse than the CAGE, especially when a reduced criterion score was employed.
Archives of General PsychiatryHealth Care Costs of Primary Care Patients With Recognized Depression
535 Citations1995Gwendal Simon
D diagnosis of depression is associated with a generalized increase in use of health services that is only partially explained by comorbid medical conditions, and in the primary care sector, this greater medical utilization exceeds direct treatment costs for depression.
Archives of General PsychiatryDisability and Depression Among High Utilizers of Health Care
529 Citations1992Michael Von Korff
Medical CareAdequacy and Duration of Antidepressant Treatment in Primary Care
523 Citations1992Wayne Katon, Michael Von Korff +3 more
Analysis of data on the duration of antidepressant therapy for all health maintenance organization enrollees initiating use of antidepressants showed that only 20% of patients who had been given prescriptions for first-generation antidepressants filled four or more prescriptions in the following six months, compared to 34% of Patients who had prescriptions for newer antidepressants.
Archives of Family MedicineRecognition, management, and outcomes of depression in primary care
522 Citations1995Gregory E. Simon
While many depressed primary care patients may go unrecognized and untreated, this group appears to have milder and more self-limited depression.
General Hospital PsychiatryDistressed high utilizers of medical care
510 Citations1990Wayne Katon, Michael Von Korff +5 more
Among a sample of 767 high utilizers of health care, 51% were identified as distressed by an elevated score on the SCL anxiety and depression scales, theSCL somatization scale, or by their primary-care physician, and two thirds had a lifetime history of major depression.
BMJRandomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in primary care
496 Citations1995Laurence Mynors‐Wallis, Dennis Gath +2 more
This study found that problem solving is an effective psychological treatment for major depression in primary care—as effective as amitriptyline and more effective than placebo.
Archives of General PsychiatryTreating Major Depression in Primary Care Practice
433 Citations1996Herbert C. Schulberg
Severity of depressive symptoms was reduced more rapidly and more effectively among patients randomized to pharmacotherapy or psychotherapy than among patients assigned to a physician's usual care.
American Journal of PsychiatryTreatment outcomes for primary care patients with major depression and lifetime anxiety disorders
317 Citations1996Claire M. Brown, Herbert C. Schulberg +3 more
Standardized psychotherapy and pharmacotherapy are effective for patients with major depression with and without a generalized anxiety disorder, however, the longer time to recovery for the former group and lack of response to these treatments by patients with lifetime panic disorder suggest that primary care physicians should carefully assess history of anxiety disorder among depressed patients.
Journal of the American Geriatrics SocietyImproving Treatment of Late Life Depression in Primary Care: A Randomized Clinical Trial
309 Citations1994Christopher M. Callahan, Hugh C. Hendrie +4 more
Primary care physicians' compliance with recommended standards of care for late life depression by reducing barriers to recognition and treatment is facilitated.
General Hospital PsychiatryPatterns of antidepressant use in community practice
282 Citations1993Gregory E. Simon, Michael VonKorff +2 more
Analysis of patterns of antidepressant use by primary care physicians and psychiatrists in a large staff-model health maintenance organization suggests more intensive antidepressant treatment than in earlier reports, especially in primary care.
Medical CareAchieving Guidelines for the Treatment of Depression in Primary Care
236 Citations1997Elizabeth Lin, Wayne Katon +6 more
The results suggest that continuing programs of reorganized service delivery to support the role of a primary care physician (eg, on-site mental health personnel, close monitoring of patient progress and adherence) are essential for the success of guideline implementation.
American Journal of PsychiatryUse of minor tranquilizers and antidepressant medications by depressed outpatients: results from the medical outcomes study
225 Citations1994Kenneth B. Wells, Wayne Katon +2 more
Use of antidepressant medications among patients of nonphysicians was unrelated to the level of psychological sickness, suggesting the need for more cooperation among provider groups.
Archives of Internal MedicineTreating Depressed Primary Care Patients Improves Their Physical, Mental, and Social Functioning
217 Citations1997John L. Coulehan
Primary care patients with major depressive disorder report substantial impairments in physical, psychological, and social functioning on initial assessment, but standardized depression-specific treatment is associated with greater improvement in more domains of functioning than is a physician's usual care.
BMJTwelve month outcome of depression in general practice: does detection or disclosure make a difference?
207 Citations1995Christopher Dowrick, Iain Buchan
Disclosure of undetected depression did not improve prognosis, and a diagnosis of depression in general practice should be considered simply as a marker of its severity.
American Journal of Psychiatry12-month outcome of patients with major depression and comorbid psychiatric or medical illness (compound depression)
187 Citations1991Gabor I. Keitner, Christine E. Ryan +3 more
Compound depression is a common clinical occurrence, the course of illness is more difficult for Patients with compound depression than for patients with pure depression, and the recovery rate of patients with compounds depression is lower than that of patientsWith pure depression.
Biological PsychiatrySertraline safety and efficacy in major depression: A double-blind fixed-dose comparison with placebo
184 Citations1995Louis F. Fabre, F.S. Abuzzahab +6 more
The results of this study show that sertraline 50 mg once daily is as effective as higher dosages for the treatment of major depression with fewer side effects and therapy discontinuations.
The Joint Commission Journal on Quality ImprovementA Randomized Controlled Trial of CQI Teams and Academic Detailing: Can They Alter Compliance with Guidelines?
183 Citations1998Harold I. Goldberg, Edward H. Wagner +7 more
The AD techniques and the CQI teams evaluated were generally ineffective in improving guideline compliance and clinical outcomes regarding the primary care of hypertension and depression.
General Hospital PsychiatryA randomized trial of psychiatric consultation with distressed high utilizers
155 Citations1992Wayne Katon, Michael Von Korff +5 more
Psychiatric consultation was associated with a significant increase in the use of antidepressants in intervention patients compared with controls in the first 6 months after intervention, and intervention patients were significantly more likely to continue antidepressant treatment than control patients.
Archives of Family MedicineThe 'usual care' of major depression in primary care practice
135 Citations1997Herbert C. Schulberg
The recovery rates for the patients with major depression who were treated with usual care in routine primary care practices were lower than those anticipated from treatments consistent with the Agency for Health Care Policy and Research guidelines.
Journal of General Internal MedicineDepression among high utilizers of medical care
133 Citations1999Steven D. Pearson, David J. Katzelnick +4 more
Although there was evidence that mental health problems had previously been recognized in many of the patients, a large percentage of high utilizers still suffered from active depression that either went unrecognized or was not being treated successfully.
Archives of General PsychiatryMedical Costs Attributed to Depression Among Patients With a History of High Medical Expenses in a Health Maintenance Organization
131 Citations1996Henry J. Henk
Whether a positive screen for depression is predictive of continued high medical expenditures in high utilizers is determined and the total medical cost associated with depression in 1994, adjusted for age, sex, benefits package, and medical comorbidity, was $1498 per patient.
Psychiatric ServicesEffect of primary care treatment of depression on service use by patients with high medical expenditures
84 Citations1997David J. Katzelnick, Kenneth A. Kobak +3 more
Identification and treatment of depression among patients with a history of high medical expenditures improved depression and increased work productivity and quality of life.
International Clinical PsychopharmacologyClinical efficacy of mirtazapine: a review of meta-analyses of pooled data
80 Citations1995Siegfried Kasper
It can be concluded that the new antidepressant mirtazapine offers distinct therapeutic benefits for a variety of depressed patients in either in- or outpatient settings.
Journal of Clinical PsychopharmacologyFluvoxamine Maleate in the Treatment of Depression
54 Citations1996James L. Claghorn, Craig Q. Earl +5 more
The data clearly demonstrate the antidepressant activity and tolerability of fluvoxamine maleate (50-150 mg/day) as compared with placebo; it is also as effective as the tricyclic antidepressant imipramine (80-240 mg/ day) in patients with major depressive disorder.
PharmacopsychiatryInterpersonal Psychotherapy (IPT) and Drugs in the Treatment of Depression<sup>1,2</sup>
45 Citations1987Gerald L. Klerman, Maike V Weissmann
IPT is a brief form of psychotherapy, developed specifically for treatment of depression, based on the theoretical writings of Meyer and Sullivan and empirical research from epidemiology and clinical investigations.
Archives of Family MedicineApplicability of clinical pharmacotherapy guidelines for major depression in primary care settings
40 Citations1995Herbert C. Schulberg
The treatment of depressed primary care patients within AHCPR guidelines for antidepressant medication is feasible but complex and keeping patients in treatment is difficult and possibly requires greater flexibility in treatment regimens.
International Clinical PsychopharmacologyA Double-Blind Comparison of Paroxetine, Imipramine and Placebo in Depressed Outpatients
23 Citations1992John P. Feighner
A large multicentre, randomized, placebo-controlled, double-blind, parallel design study in the USA indicated that paroxetine was an effective and well-tolerated antidepressant.
Journal of Affective DisordersMethodological problems in the estimation of the onset of the antidepressant effect
16 Citations1998Helge Müller
A review of the literature published since 1975 was carried out in order to find out if a specific pattern can be observed and points out what problems are most often encountered and illustrate the most common pitfalls.
