Depression Treatment in General Medical Setting

可以从新的抑郁症治疗中受益的临床抑郁症患者往往得不到治疗。低治疗率尤其令人担忧，因为预计到2010年，抑郁症将成为全球第二大致残原因。近年来，重度抑郁症一直是许多初级保健患者干预研究的焦点。然而，尽管在开发和测试抑郁症治疗的高质量干预模式方面取得了进展，但对拉丁裔干预的有效性知之甚少。这一点很重要，因为拉美裔接受抑郁症治疗的可能性低于白人，尽管这两个群体的抑郁率相似。一个重大的公共卫生挑战 是让社会上所有群体都能从抑郁症治疗的干预进展中受益。作为第一步，该应用程序寻求支持，以检查波多黎各人高质量抑郁症干预的影响。具体目标是： 1.检验协作性抑郁管理计划在普通医疗环境下减轻波多黎各患者抑郁症状、提高生活质量和减少与健康相关的功能损害方面的效果。 2.确定协作性抑郁管理计划在提高波多黎各普通医疗机构患者的护理满意度和减少抑郁症治疗障碍方面是否有效。 本研究将采用随机实验设计。接受一般医疗护理的抑郁症患者将被分配到两种情况之一：80人接受抑郁管理计划，80人像往常一样接受治疗。所有受试者将在基线、第8周、第16周和第24周完成评估。我们的总体方案目标是增加抑郁症患者得到护理的可能性，并使波多黎各社区在治疗严重抑郁症方面取得进展。

Clinically depressed individuals that could benefit from newer treatments for depression often do not receive care. Low treatment rates are of particular concern since depression is projected to be the second leading cause of disability worldwide by 2010. Major depression has been the focus of numerous intervention studies with primary care patients during recent years. However, despite advances in the development and testing of quality intervention models for depression treatment, very little is known about the effectiveness of interventions with Latinos. This is important because Latinos are less likely than whites to receive depression treatment, even though the rates of depression are similar for both groups. A major public health challenge is to make available the benefits of intervention developments in depression treatment for all groups in society. As a first step, this application seeks support to examine the impact of a quality depression intervention with Puerto Ricans. The specific aims are: 1. To examine the effect of a Collaborative Depression Management Program in reducing depressive symptoms, improving quality of life, and decreasing health-related functional impairment among Puerto Rican patients in general medical settings. 2. To determine whether a Collaborative Depression Management Program is effective in improving satisfaction with care and reducing barriers to depression treatment among Puerto Rican patients in general medical settings. This study will employ a randomized experimental design. Depressed patients receiving general medical care will be assigned to one of two conditions: 80 to the Depression Management Program and 80 to treatment as usual. All subjects will complete assessments at baseline, week 8, week 16, and week 24. Our overall programmatic goals are to increase the likelihood that depressed patients receive care and to make available for the Puerto Rican community advances in the treatment of major depression.