Abstract: Objective: To determine the 12-month cost-effectiveness of a collaborative care (CC) program for treating depression following coronary artery bypass graft (CABG) surgery versus physicians’ usual care (UC).Methods: We obtained 12 continuous months of Medicare and private medical insurance claims data on 189 patients who screened positive for depression following CABG surgery, met criteria for depression when reassessed by telephone two-weeks following hospitalization (9-item Patient Health Questionnaire ?10), and were randomized to either an 8-month centralized, nurse-provided, and telephone-delivered collaborative care (CC) intervention for depression or to their physicians’ usual care (UC).Results: At 12-months following randomization, CC patients had $2,068 lower but statistically similar estimated median costs compared to UC (P=0.30) and a variety of sensitivity analyses produced no significant changes. The incremental cost effectiveness ratio of CC was -$9,889 (-$11,940 to -$7,838) per additional quality-adjusted life-year (QALY), and there was 90% probability it would be cost-effective at the willingness to pay threshold of $20,000 per additional QALY.
Abstract: Objective: To examine the relationship of poor dental health and depression, controlling for markers of inflammation (C-Reactive Protein; CRP) and adiposity (Body Mass Index; BMI).Method: Data from two National Health and Nutrition Examination Surveys (NHANES) (2005–2008) were utilized (n=10, 214). Dental health was assessed using the Oral Health Questionnaire (OHQ). Depression was measured using the Patient Health Questionnaire-9 (PHQ-9), where cases were identified using a cut off score of 10 or above.
Abstract: Objective: Persons with thoughts of self-harm may need evaluation for suicide risk. We examine the prevalence of thoughts of self-harm and whether persons with thoughts of self-harm are identified when two-stage depression screening is used.Methods: Data are from the 2005–2010 National Health and Nutrition Examination Surveys. Persons responding positively to question nine of the Patient Health Questionnaire-9 (PHQ-9) are identified as having thoughts of self-harm.
Abstract: Objectives: To determine nationally representative estimates of the prevalence of depressive symptoms and factors associated with treatment among those with moderate to severe symptoms.Methods: A cross-sectional, retrospective analysis of adults age?18 in the 2005–2010 NHANES data who responded to the Patient Health Questionnaire (PHQ-9) was conducted (n=13,320). Depressive symptoms and severity were defined by PHQ-9 scores. Depression treatment was defined as receiving either antidepressants or seeing a mental health professional.
Abstract: Objective: This study examined differences in co-occurring symptoms, psychosocial correlates, health care utilization and functional impairment in youth who screened positive for depression, stratified by whether or not they also self-reported externalizing problems.Methods: The AdoleSCent Health Study examined a random sample of youth ages 13–17 enrolled in a health care system. A total of 2291 youth (60.7% of the eligible sample) completed a brief depression screen: the two-item Patient Health Questionnaire. The current analyses focus on a subset of youth (n=113) who had a follow-up interview and screened positive for possible depression on the Patient Health Questionnaire 9 using a cutoff score of 11 or higher .
Abstract: Objective: The objective was to describe the design, implementation and preliminary results of a collaborative care pilot program using hybrid colocation and centralized care management for patients with depression and chronic medical illness in an urban accountable care organization.Methods: Patients with chronic illness (diabetes mellitus, coronary artery disease and/or congestive heart failure) and comorbid depressive symptoms (Patient Health Questionnaire [PHQ]9 score ?10) were enrolled. The interventions included collaborative care for depression and chronic conditions; behavioral support, including short-term psychotherapy by licensed clinical social worker on-site or telephonically; off-site nurse care management and psychiatrist consultation through an electronic medical record.Results: Forty-four percent of patients (n=61) achieved a depression response.
Abstract: Objective: In high-income countries, the number and severity of somatic symptoms — irrespective of etiology — are associated with adverse psychobehavioral and functional characteristics. This study aimed to assess these key features among Chinese general hospital outpatients with high levels of somatic symptoms.Methods: This multicenter, cross-sectional study evaluated four outpatient departments of internal medicine and Traditional Chinese Medicine in Beijing and Kunming and enrolled a total of 281 consecutive patients. The patients answered questionnaires concerning somatic symptom severity [Patient Health Questionnaire (PHQ-15)], illness perception (Brief Illness Perception Questionnaire), illness behavior (Scale for the Assessment of Illness Behavior), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (12-Item Short Form Health Survey)
Abstract: Objective: In Europe and the US, primary care has been anticipated in identifying untreated depression. Findings show a high prevalence of depression in such settings. However, the prevalence of depression in an internal medicine clinic in a rural area of Japan, which has a role in primary care, is unclear.Method: The prevalence of depression and comorbid psychiatric disorders among outpatients of an internal medicine clinic in a rural general hospital was measured by a structured interview using the Mini International Neuropsychiatric Interview.
Abstract: Background: The nine-item depression module from the Patient Health Questionnaire (PHQ-9) is widely used as an open access screening instrument for depression in different health care and community settings; thus far, normative data from the general population are still scarce. The objectives of the study were to generate normative data and to further investigate the construct validity and factor structure of the PHQ-9 in the general population.Methods: Nationally representative face-to face household surveys were conducted in Germany between 2003 and 2008 (n=5018). The survey questionnaires included the PHQ-9, the Satisfaction with Life Scale, the 12-item Short Form Health Survey (SF-12) for the measurement of health-related quality of life and demographic characteristics.Results: Normative data for the PHQ-9 were generated for both genders (53.6% female) and different age levels [mean age (S.D.) of 48.9 (18.1) years].
Abstract: Objective: The objective was to identify risk factors for posttraumatic stress disorder (PTSD) and depressive symptoms after medical–surgical intensive care unit (ICU) admission.Method: This longitudinal investigation included 150 medical–surgical ICU patients. We assessed acute stress and post-ICU PTSD symptoms with the PTSD Checklist-Civilian Version and post-ICU depressive symptoms with the Patient Health Questionnaire-9. Mixed-model linear regression ascertained associations between patient and clinical characteristics and repeated measures of post-ICU PTSD and depressive symptoms.Results: The prevalences of substantial PTSD and depressive symptoms were 16% and 31% at 3 months post-ICU and 15% and 17% at 12 months post-ICU, respectively