Culturally Sensitive Treatment for Depressed Asians

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): This is a resubmission of an application for a mentored patient-oriented K-23 award, designed to enhance clinical training and research expertise in the area of treatment of depression among Asian Americans. This application differs from the original one in that face to face interviews will be used for screening of depression in primary care clinic instead of using telephone interviewers; hypotheses are added to assess if degree of acculturation and illness beliefs predict treatment outcomes; and involvement of patients' family members for psychoeducation and family counseling will be provided if necessary. Preliminary studies from the candidate and the Depression Clinical and Research Program at the Massachusetts General Hospital have shown that depression is prevalent among Asian Americans and many of these patients are unfamiliar with the concept of depression. Depressed Asian Americans frequently do not complain about their mood symptoms leading to under-recognition of their illness. Recognition of depressed Asian Americans in primary care alone does not result in adequate treatment by primary care physicians. We are proposing a comprehensive approach: Culturally Sensitive Collaborative Treatment (CSCT) for treating depressed Asian Americans in primary care. CSCT includes Cultural Consultation to depressed patients by a psychiatrist trained in cultural sensitivity to introduce the concept of depression, treatment of depression by primary care physicians based on established guidelines, and Care Management by a bilingual and bicultural Care Manager under the supervision of a psychiatrist. The goal of this project is to evaluate the effectiveness of this innovative approach compared to usual care. The proposed study will be based at the Massachusetts General Hospital in the Depression Clinical and Research Program, under the mentorship of Dr. Maurizio Fava, MD, and will include consultation from experts in this research area. There will also be a didactic component to the project, include coursework in the cultural aspects of mental illness, methodology of health service research, cost-effectiveness analysis, and ethics. The development of a larger scale R01 project involving different sites and different groups of Asian Americans will be started during the last 2 years of the award period.