TREATMENT OF DEPRESSION IN DISADVANTAGED GYNECOLOGY PATI

这项研究比较了两种已建立的治疗方法的有效性， 抑郁症、抗抑郁药和短期认知障碍 行为疗法在公共部门妇科病人。他们研究 因为抑郁症在年轻女性中最常见， 经常使用医疗服务的人。的年轻女性 经常使用医疗服务的人经常被妇科医生看到 而不是初级保健。在他们对205名公众的试点研究中， 妇科患者中，21%符合主要 抑郁症，但只有19%的抑郁症患者获得了 治疗这项研究将确定两个有效性 为年轻的非裔美国人建立了抑郁症的治疗方法， 拉丁裔，和白色妇女看到在王子乔治的县，马里兰州公共 部门妇科诊所。我们将确定精神病的发病率 疾病，以及身体和性侵犯，在一个样本， 3,886名女性接受了这项研究的筛查。此外，他们将 确定抑郁症，身体攻击史， 以及这些年轻人使用医疗服务的性侵犯史 妇女共有450名妇女（非洲裔美国人、拉丁裔和 白色）符合DSM-IV标准的重度抑郁症患者将被随机 分配到药物治疗，认知行为团体治疗，或 妇科护理照常进行评估将在接收时进行， 治疗和6个月随访。假设那些接受 药物治疗或团体治疗将报告较少的抑郁 治疗后，神经系统和功能状态改善， 与普通女性相比，他们将研究 后续医疗利用的治疗。此外，他们将 确定攻击史是否影响抑郁症治疗 结果。终于来了他们将研究两者的成本效益， 治疗，结果包括抑郁性神经病学和 功能状态

This study compares the effectiveness of two established treatments for major depression, anti-depressant medication and short-term cognitive behavioral therapy in public sector gynecology patients. They study these women because depression is most common among young women and among those who frequently use medical services. Young women who are frequent users of medical services are often seen by gynecologists rather than primary care setting. In their pilot study of 205 public sector gynecology patients, 21 percent met criteria for major depression, yet only 19 percent of those who are depressed had obtained treatment. This study will determine the effectiveness of two established treatments for depression for young African American, Latina, and White women seen in Prince George's county , Maryland public sector gynecology clinics. We will determine the rates of psychiatric disorders, as well as physical and sexual assault, among a sample of 3,886 women being screened for the study. In addition, they will determine the relationship of depression, history of physical assault, and history of sexual assault on use of medical services by these young women. A total of 450 women (150 each African-American, Latina and White) who meet DSM-IV criteria for major depression will be randomly assigned to pharmaco-therapy, cognitive behavioral group therapy, or gynecological care as usual. Evaluations will occur at intake, post- treatment, and 6 months follow-up. The hypothesize that those receiving pharmacotherapy or group therapy will report less depressive symptomalogy and improved functional status following treatment as compared with the care as usual women. They will examine the impact of treatments on subsequent medical utilization. In addition, they will determine whether history of assault impacts on depression treatment outcomes. Finally. they will examine the cost-effectiveness of the two treatments, with outcomes including both depressive symptomalogy and functional status.