Collaborative care for adolescents with depression in primary care: a randomized clinical trial.
Identifieur interne : 002169 ( PubMed/Corpus ); précédent : 002168; suivant : 002170Collaborative care for adolescents with depression in primary care: a randomized clinical trial.
Auteurs : Laura P. Richardson ; Evette Ludman ; Elizabeth Mccauley ; Jeff Lindenbaum ; Cindy Larison ; Chuan Zhou ; Greg Clarke ; David Brent ; Wayne KatonSource :
- JAMA [ 1538-3598 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Depression.
- therapy : Depression.
- Adolescent, Female, Humans, Male, Mental Health Services, Patient Care Team, Primary Health Care, Treatment Outcome.
Abstract
Up to 20% of adolescents experience an episode of major depression by age 18 years yet few receive evidence-based treatments for their depression.
DOI: 10.1001/jama.2014.9259
PubMed: 25157724
Links to Exploration step
pubmed:25157724Le document en format XML
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<author><name sortKey="Zhou, Chuan" sort="Zhou, Chuan" uniqKey="Zhou C" first="Chuan" last="Zhou">Chuan Zhou</name>
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<author><name sortKey="Clarke, Greg" sort="Clarke, Greg" uniqKey="Clarke G" first="Greg" last="Clarke">Greg Clarke</name>
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<author><name sortKey="Brent, David" sort="Brent, David" uniqKey="Brent D" first="David" last="Brent">David Brent</name>
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<author><name sortKey="Zhou, Chuan" sort="Zhou, Chuan" uniqKey="Zhou C" first="Chuan" last="Zhou">Chuan Zhou</name>
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<author><name sortKey="Clarke, Greg" sort="Clarke, Greg" uniqKey="Clarke G" first="Greg" last="Clarke">Greg Clarke</name>
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<author><name sortKey="Brent, David" sort="Brent, David" uniqKey="Brent D" first="David" last="Brent">David Brent</name>
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<series><title level="j">JAMA</title>
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<term>Depression (diagnosis)</term>
<term>Depression (therapy)</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Health Services</term>
<term>Patient Care Team</term>
<term>Primary Health Care</term>
<term>Treatment Outcome</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Depression</term>
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<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Health Services</term>
<term>Patient Care Team</term>
<term>Primary Health Care</term>
<term>Treatment Outcome</term>
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<front><div type="abstract" xml:lang="en">Up to 20% of adolescents experience an episode of major depression by age 18 years yet few receive evidence-based treatments for their depression.</div>
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<Month>12</Month>
<Day>15</Day>
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<Issue>8</Issue>
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<Title>JAMA</Title>
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<ArticleTitle>Collaborative care for adolescents with depression in primary care: a randomized clinical trial.</ArticleTitle>
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<ELocationID EIdType="doi" ValidYN="Y">10.1001/jama.2014.9259</ELocationID>
<Abstract><AbstractText Label="IMPORTANCE" NlmCategory="OBJECTIVE">Up to 20% of adolescents experience an episode of major depression by age 18 years yet few receive evidence-based treatments for their depression.</AbstractText>
<AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To determine whether a collaborative care intervention for adolescents with depression improves depressive outcomes compared with usual care.</AbstractText>
<AbstractText Label="DESIGN" NlmCategory="METHODS">Randomized trial with blinded outcome assessment conducted between April 2010 and April 2013.</AbstractText>
<AbstractText Label="SETTING" NlmCategory="METHODS">Nine primary care clinics in the Group Health system in Washington State.</AbstractText>
<AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">Adolescents (aged 13-17 years) who screened positive for depression (Patient Health Questionnaire 9-item [PHQ-9] score ≥10) on 2 occasions or who screened positive and met criteria for major depression, spoke English, and had telephone access were recruited. Exclusions included alcohol/drug misuse, suicidal plan or recent attempt, bipolar disorder, developmental delay, and seeing a psychiatrist.</AbstractText>
<AbstractText Label="INTERVENTIONS" NlmCategory="METHODS">Twelve-month collaborative care intervention including an initial in-person engagement session and regular follow-up by master's-level clinicians. Usual care control youth received depression screening results and could access mental health services through Group Health.</AbstractText>
<AbstractText Label="MAIN OUTCOMES AND MEASURES" NlmCategory="METHODS">The primary outcome was change in depressive symptoms on a modified version of the Child Depression Rating Scale-Revised (CDRS-R; score range, 14-94) from baseline to 12 months. Secondary outcomes included change in Columbia Impairment Scale score (CIS), depression response (≥50% decrease on the CDRS-R), and remission (PHQ-9 score <5).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Intervention youth (n = 50), compared with those randomized to receive usual care (n = 51), had greater decreases in CDRS-R scores such that by 12 months intervention youth had a mean score of 27.5 (95% CI, 23.8-31.1) compared with 34.6 (95% CI, 30.6-38.6) in control youth (overall intervention effect: F2,747.3 = 7.24, P < .001). Both intervention and control youth experienced improvement on the CIS with no significant differences between groups. At 12 months, intervention youth were more likely than control youth to achieve depression response (67.6% vs 38.6%, OR = 3.3, 95% CI, 1.4-8.2; P = .009) and remission (50.4% vs 20.7%, OR = 3.9, 95% CI, 1.5-10.6; P = .007).</AbstractText>
<AbstractText Label="CONCLUSIONS AND RELEVANCE" NlmCategory="CONCLUSIONS">Among adolescents with depression seen in primary care, a collaborative care intervention resulted in greater improvement in depressive symptoms at 12 months than usual care. These findings suggest that mental health services for adolescents with depression can be integrated into primary care.</AbstractText>
<AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">clinicaltrials.gov Identifier: NCT01140464.</AbstractText>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Richardson</LastName>
<ForeName>Laura P</ForeName>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
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<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
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<MeshHeading><DescriptorName UI="D008605" MajorTopicYN="N">Mental Health Services</DescriptorName>
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<MeshHeading><DescriptorName UI="D010348" MajorTopicYN="Y">Patient Care Team</DescriptorName>
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<MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
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