MINOR DEPRESSION--PSYCHOSOCIAL TREATMENT IN PRIMARY CARE

描述（改编自申请人的摘要）： 培训和研究概述了这一修订后的申请， 临床医生科学家发展奖（SDAC）专注于发展 候选人应用随机临床试验的专业知识 方法论的临床服务研究在初级保健环境， 和赫伯特C. Schulberg博士，精神病学、心理学教授， 匹兹堡大学医学院医学博士，担任导师。 职业发展计划包括精神病学和医学方面的培训。 流行病学、心理测量学、卫生经济学和生物统计学。 计划中的教程是“将行为干预纳入初级教育”， 卫生保健”与“精神病治疗的成本-效果评价” 在初级保健治疗。“拟议的研究评估了 初级保健中心理社会治疗的疗效和康复过程 轻度抑郁症患者。 越来越多的证据表明，主观幸福感的严重受损- 健康状况和功能状态，以及增加的医疗保健利用率， 与轻度抑郁症有关然而，有效和可行的治疗方法 选择很少受到关注。一项随机临床试验 在匹兹堡的四个城市健康中心进行，PA被提议 检查护士提供的问题解决疗法（PST）的有效性 为轻度抑郁症患者提供初级护理的临床医生。的 临床护士提供的PST结果将与 接受初级护理的患者的结局 护理医师。护士提供的治疗的完整性将 将由候选人在考试期间制定一个量表进行评估。 研究的启动阶段。将评估PST的疗效 通过多个领域，包括症状和功能 治疗后的变化。据推测，患者接受 PST将显示出比那些更大的症状和功能改善 接受常规护理。此外，一项关于成本的试点研究- PST在初级保健轻度抑郁症患者中有效性 在颁奖期间进行。

DESCRIPTION (Adapted from the Applicant's Abstract): The program of training and research outlined in this revised application for a Scientist Development Award for Clinicians (SDAC) focuses on developing the candidate's expertise in applying randomized clinical trails methodology to clinical services research in a primary care setting, with Herbert C. Schulberg, Ph.D., Professor of Psychiatry, Psychology, and Medicine, University of Pittsburgh School of Medicine, as Preceptor. The career development plans include training in psychiatric and medical epidemiology, psychometrics, health economics, and biostatistics. Planned tutorials are "Integrating Behavioral Interventions into Primary Health Care" and "Evaluating the Cost-Effectiveness of Psychiatric Treatment in Primary Care." The proposed research evaluates the efficacy of psychosocial treatment and course of recovery in primary care patients with minor depression. There is growing evidence that significant impairment in subjective well- being and functional status, and increased health care utilization are associated with minor depression. Yet, effective and feasible treatment options have received little attention. A randomized, clinical trial conducted at four urban health centers in Pittsburgh, PA is proposed to examine the efficacy of problem-solving therapy (PST) provided by nurse clinicians for primary care patients with minor depression. The outcomes of PST provided by nurse clinicians will be compared to the outcomes experienced by patients receiving usual care from their primary care physician. The integrity of the treatment provided by nurses will be evaluated with a scale to be developed by the candidate during the start-up phase of the study. The efficacy of PST will be assessed through multiple domains, including both symptomatic and functional changes following treatment. It is hypothesized that patients receiving PST will show greater symptomatic and functional improvement than those receiving usual care. Additionally, a pilot study of the cost- effectiveness of PST in primary care patients with minor depression will be undertaken during the award period.