TY - JOUR
AU - M. K. Williams
AU - A. L. Shell
AU - W. Wu
AU - K. L. MacDonald
AU - C. M. Callahan
AU - J. I. Nurnberger Jr.
AU - C. A. Crawford
AU - M. D. Schuiling
AU - J. C. Stewart
A1 - 
AB - BACKGROUND: Integrating digital mental health into collaborative care could address multiple mental health factors. To determine the longer-term effects of modernized collaborative care for depression on overlapping mental health factors, we analyzed data from the eIMPACT trial. METHODS: Primary care patients with depression and elevated cardiovascular disease risk (N = 216, Mage: 59 years, 78 % female, 50 % Black, 46 % with income <$10,000/year) were randomized to 12 months of the eIMPACT intervention (modernized collaborative care involving internet cognitive-behavioral therapy [iCBT], telephonic CBT, and/or select antidepressants) or usual primary care for depression. Depressive symptoms (Hopkins Symptom Checklist-20 [SCL-20] and Patient Health Questionnaire-9 [PHQ-9]), anxiety symptoms (Generalized Anxiety Disorder-7 [GAD-7]), hostility/anger/aggression (Buss-Perry Aggression Questionnaire [BPAQ]), and trait positive affect (Positive and Negative Affect Schedule-Positive Affect Subscale [PANAS-PA]) were measured at 0, 6, 12, and 24 months. RESULTS: Compared to the usual care group, the intervention group exhibited significant improvements across all outcomes. The intervention group advantage increased over the treatment period, peaked at post-treatment (12 months: SCL-20 d(adj) = -0.57, PHQ-9 d(adj) = -0.63, GAD-7 d(adj) = -0.50, BPAQ d(adj) = -0.17, PANAS-PA d(adj) = 0.41), and decreased over the follow-up period (24 months: SCL-20 d(adj) = -0.24, PHQ-9 d(adj) = -0.29, GAD-7 d(adj) = -0.20, BPAQ d(adj) = 0.06, PANAS-PA d(adj) = 0.17). CONCLUSIONS: Modernized collaborative care improved multiple mental health factors, highlighting the feasibility and longer-term benefits of blending collaborative care and digital mental health across racial, education, and income groups. Future implementation of such interventions could promote equitable access to high-quality care. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02458690.
AD - Department of Psychology, Indiana University Indianapolis, 402 N. Blackford St., LD 100E, Indianapolis, IN, USA.; Outpatient Behavioral Health, Indiana University Health, Indianapolis, IN, USA.; Department of Psychology, Indiana University Indianapolis, 402 N. Blackford St., LD 100E, Indianapolis, IN, USA; Sandra Eskenazi Mental Health Center, Eskenazi Health, Indianapolis, IN, USA.; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Health, Indianapolis, IN, USA.; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.; Department of Psychology, Indiana University Indianapolis, 402 N. Blackford St., LD 100E, Indianapolis, IN, USA. Electronic address: jstew@iu.edu.
AN - 40930184
BT - J Affect Disord
C5 - HIT & Telehealth
DA - Jan 1
DO - 10.1016/j.jad.2025.120272
DP - NLM
ET - 20250908
JF - J Affect Disord
LA - eng
N2 - BACKGROUND: Integrating digital mental health into collaborative care could address multiple mental health factors. To determine the longer-term effects of modernized collaborative care for depression on overlapping mental health factors, we analyzed data from the eIMPACT trial. METHODS: Primary care patients with depression and elevated cardiovascular disease risk (N = 216, Mage: 59 years, 78 % female, 50 % Black, 46 % with income <$10,000/year) were randomized to 12 months of the eIMPACT intervention (modernized collaborative care involving internet cognitive-behavioral therapy [iCBT], telephonic CBT, and/or select antidepressants) or usual primary care for depression. Depressive symptoms (Hopkins Symptom Checklist-20 [SCL-20] and Patient Health Questionnaire-9 [PHQ-9]), anxiety symptoms (Generalized Anxiety Disorder-7 [GAD-7]), hostility/anger/aggression (Buss-Perry Aggression Questionnaire [BPAQ]), and trait positive affect (Positive and Negative Affect Schedule-Positive Affect Subscale [PANAS-PA]) were measured at 0, 6, 12, and 24 months. RESULTS: Compared to the usual care group, the intervention group exhibited significant improvements across all outcomes. The intervention group advantage increased over the treatment period, peaked at post-treatment (12 months: SCL-20 d(adj) = -0.57, PHQ-9 d(adj) = -0.63, GAD-7 d(adj) = -0.50, BPAQ d(adj) = -0.17, PANAS-PA d(adj) = 0.41), and decreased over the follow-up period (24 months: SCL-20 d(adj) = -0.24, PHQ-9 d(adj) = -0.29, GAD-7 d(adj) = -0.20, BPAQ d(adj) = 0.06, PANAS-PA d(adj) = 0.17). CONCLUSIONS: Modernized collaborative care improved multiple mental health factors, highlighting the feasibility and longer-term benefits of blending collaborative care and digital mental health across racial, education, and income groups. Future implementation of such interventions could promote equitable access to high-quality care. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02458690.
PY - 2026
SN - 0165-0327
SP - 120272
ST - Longer-term effects of modernized collaborative care for depression on multiple mental health factors (eIMPACT): A randomized controlled trial
T1 - Longer-term effects of modernized collaborative care for depression on multiple mental health factors (eIMPACT): A randomized controlled trial
T2 - J Affect Disord
TI - Longer-term effects of modernized collaborative care for depression on multiple mental health factors (eIMPACT): A randomized controlled trial
U1 - HIT & Telehealth
U3 - 10.1016/j.jad.2025.120272
VL - 392
VO - 0165-0327
Y1 - 2026
ER -