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The Literature Collection contains over 11,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
11231 Results
2861
Depression during perimenopause: the role of the obstetrician-gynecologist
Type: Journal Article
Year: 2020
Publication Place: Austria
Abstract: Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.
Topic(s):
General Literature
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Reference Links: 
View the DOI record for Depression during perimenopause: the role of the obstetrician-gynecologist
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View the PubMed citation for Depression during perimenopause: the role of the obstetrician-gynecologist2862
Depression during perimenopause: the role of the obstetrician-gynecologist
Type: Journal Article
Year: 2020
Publication Place: Austria
Abstract: Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for Depression during perimenopause: the role of the obstetrician-gynecologist
View DOI Record
View the PubMed citation for Depression during perimenopause: the role of the obstetrician-gynecologist2865
Depression in African Americans: Breaking barriers to detection and treatment
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: OBJECTIVE: Recent studies in primary care settings indicate that African Americans face health disparities in the treatment of major depression. We reviewed the literature to find evidence of specific patient, physician, and practice-setting factors related to such barriers. DATA SOURCES: We searched for and retrieved articles in Medline (1966-2004) and hand-checked bibliographies to find additional articles that were relevant to the evaluation and treatment of African Americans with depression. STUDY SELECTION AND DATA EXTRACTION: Two investigators (AKD, MO) independently examined the abstracts retrieved from the literature search, and excluded articles that did not match a predefined search strategy. Two other investigators (HLC, MMW) identified potential articles through bibliographic review. In the extracted set articles, we examined cited barriers to diagnosis and effective management. RESULTS: We found 24 articles that fulfilled our criteria. These studies indicate that African Americans face a number of barriers in the recognition and treatment of major depression including clinical presentation with somatization, stigma about diagnosis, competing clinical demands of comorbid general medical problems, problems with the physician-patient relationship, and lack of comprehensive primary care services. CONCLUSIONS: Research indicates that African Americans who have depression may be frequently under diagnosed and inadequately managed in primary care as a result of patient, physician, and treatment-setting factors. Our systematic review can assist family physicians in understanding how to overcome such barriers to the diagnosis and treatment of depressive disorders in African American patients.
Topic(s):
Healthcare Disparities
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, Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Depression in African Americans: Breaking barriers to detection and treatment
2866
Depression in primary care: assessing suicide risk
Type: Journal Article
Year: 2017
Publication Place: Singapore
Topic(s):
General Literature
See topic collection
2868
Depression in primary care: challenges & controversies
Type: Journal Article
Year: 2014
Publication Place: India
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links: View the PubMed citation for Depression in primary care: challenges & controversies
2869
Depression in primary care: current and future challenges
Type: Journal Article
Year: 2013
Publication Place: Canada
Abstract: OBJECTIVES: To describe the current state of knowledge about detection and treatment of major depressive disorder (MDD) by family physicians (FPs), and to identify gaps in practice and current and future challenges. METHODS: We reviewed the recent literature on MDD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, or International Classification of Diseases, Revision 10) in primary care, with an emphasis on systematic reviews and meta-analyses addressing prevalence, the impact of an aging population and of chronic disease on MDD rates in primary care, detection and treatment rates by FPs, adequacy of treatment, and interventions that could improve recognition and treatment. RESULTS: About 10% of primary care patients are likely to meet criteria for MDD. The number of cases will increase as the baby boomer cohort ages and as the prevalence of chronic disease increases. The bidirectional relation between MDD and chronic disease is now firmly established. Detection and treatment rates in primary care remain low. Treatment quality is frequently inadequate in terms of follow-up and monitoring. Formal case management and collaborative care interventions are likely to provide some benefits. CONCLUSIONS: Low detection rates and low treatment rates need to be addressed. Planned reassessment may improve detection rates when the FP is uncertain whether MDD is present, but further research is needed to determine why FPs frequently do not initiate treatment, even when MDD is detected. A caring, attentive FP who monitors depressed patients is likely to have considerable placebo effect. Greater focus on integrated, concurrent treatment for MDD and chronic physical diseases in the middle-aged and elderly is also required.; Publisher: Abstract available from the publisher.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Depression in primary care: current and future challenges
2871
Depression in primary care: Strategies for a psychiatry-scarce environment
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Depression in primary care: Strategies for a psychiatry-scarce environment
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View the PubMed citation for Depression in primary care: Strategies for a psychiatry-scarce environment2872
Depression in primary health care: From evidence to policy
Type: Journal Article
Year: 2008
Publication Place: Australia
Abstract: OBJECTIVE: To consider the implications for mental health policy of a recent synthesis of the literature on the effectiveness of different service delivery models for depression in primary care. METHODS: A discussion based on the results of several systematic reviews of primary care models for depression management. Primary care was defined broadly within a prevention, early-intervention, treatment and recovery/support framework, and incorporated both community and general practice settings. RESULTS: There were promising effective models for depression interventions both in the broader community and in general practice settings. CONCLUSIONS: There is a need to support evidence-based models for depression care, including innovative new technologies for facilitating consumer self-management of depression. The ability of practitioner training and guideline implementation to improve consumer outcomes for depression is limited. Policies and incentives are required to facilitate the reorganisation of general practice and, in particular, the implementation of care management as well as enhanced care and guided self-help in these settings.
Topic(s):
Education & Workforce
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, Healthcare Policy
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Reference Links: View the PubMed citation for Depression in primary health care: From evidence to policy
2873
Depression is under-recognised in the sport setting: time for primary care sports medicine to be proactive and screen widely for depression symptoms
Type: Journal Article
Year: 2016
Publication Place: England
Topic(s):
Healthcare Disparities
See topic collection
2874
Depression management interests among Alaska Native and American Indian adults in primary care
Type: Journal Article
Year: 2018
Publication Place: Netherlands
Topic(s):
Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Depression management interests among Alaska Native and American Indian adults in primary care
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View the PubMed citation for Depression management interests among Alaska Native and American Indian adults in primary care2875
Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination
Type: Journal Article
Year: 2021
Abstract:
BACKGROUND: A fully integrated Obstetric Mental Health Clinic (OBMHC) was established in 2007 in the rural northwest United States to address perinatal depression. AIMS: The purpose of this mixed methods study was to examine depression outcomes in women receiving outpatient psychiatric services between 2007 and 2017 at a fully integrated OBMHC and to explore patient and obstetric team perceptions of OBMHC experiences. METHOD: A retrospective database study was employed; depression was measured at baseline and follow-up visits using the Edinburgh Postnatal Depression Scale. Descriptive statistics, regression models, and trend analysis were employed to determine effectiveness. A subset of patients participated in telephone interviews; the obstetric team was surveyed regarding perceptions of the service. RESULTS: The sample included 192 women (195 pregnancies). Approximately 72% experienced less depression by the first follow-up visit. Patients taking three or more psychiatric medications attended more OBMHC visits. Trend analysis indicated that women with the highest levels of depression had the best response to the intervention. Three qualitative themes emerged: Safe Place, Mental/Emotional Stability, and Integrated Personalized Approach. Obstetric team members (n = 11) perceived the clinic to be helpful and noted improved access to mental health care. CONCLUSION: OBMHCs can be effective when psychiatric nurses are embedded within an outpatient obstetric service. Improved access, timely services, and patient reassurance can lead to an improved pregnancy experience and reduced depressive symptoms. The longevity of this clinic's experience serves as a role model for other centers to replicate this successful integrated model of care.
Topic(s):
Healthcare Disparities
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, Measures
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Reference Links:
View the DOI record for Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination
View DOI Record
View the PubMed citation for Depression Outcomes From a Fully Integrated Obstetric Mental Health Clinic: A 10-Year Examination2876
Depression Outcomes in Adults Attending Family Practice Were Not Improved by Screening, Stepped-Care, or Online CBT during a 12-Week Study when Compared to Controls in a Randomized Trial
Type: Journal Article
Year: 2017
Publication Place: Switzerland
Abstract: There is uncertainty regarding possible benefits of screening for depression in family practice, as well as the most effective treatment approach when depression is identified. Here, we examined whether screening patients for depression in primary care, and then treating them with different modalities, was better than treatment-as-usual (TAU) alone. Screening was carried out for depression using the 9-item Patient Health Questionnaire (PHQ-9), with a score of >/=10 indicating significant depressive symptoms. PHQ-9 scores were given to family physicians prior to patients being seen (except for the Control group). Patients (n = 1,489) were randomized to one of four groups. Group #1 were controls (n = 432) in which PHQ-9 was administered, but results were not shared. Group #2 was screening followed by TAU (n = 426). Group #3 was screening followed by both TAU and the opportunity to use an online cognitive behavioral therapy (CBT) treatment program (n = 440). Group #4 utilized an evidence-based Stepped-care pathway for depression (n = 191, note that this was not available at all clinics). Of the study sample 889 (60%) completed a second PHQ-9 rating at 12 weeks. There were no statistically significant differences in baseline PHQ-9 scores between these groups. Compared to baseline, mean PHQ-9 scores decreased significantly in the depressed patients over 12 weeks, but there were no statistically significant differences between any groups at 12 weeks. Thus, for those who were depressed at baseline Control group (Group #1) scores decreased from 15.3 +/- 4.2 to 4.0 +/- 2.6 (p < 0.001), Screening group (Group #2) scores decreased from 15.5 +/- 3.9 to 4.6 +/- 3.0 (p < 0.001), Online CBT group (Group #3) scores decreased from 15.4 +/- 3.8 to 3.4 +/- 2.7 (p < 0.01), and the Stepped-care pathway group (Group #4) scores decreased from 15.3 +/- 3.6 to 5.4 +/- 2.8 (p < 0.05). In conclusion, these findings from this controlled randomized study do not suggest that using depression screening tools in family practice improves outcomes. They also suggest that much of the depression seen in primary care spontaneously resolves and do not support suggestions that more complex treatment programs or pathways improve depression outcomes in primary care. Replication studies are required due to study limitations.
Topic(s):
General Literature
See topic collection
2878
Depression Screening Among African American Adults in the Primary Care Setting
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Education & Workforce
See topic collection
, Healthcare Disparities
See topic collection
, Measures
See topic collection
Reference Links:
View the DOI record for Depression Screening Among African American Adults in the Primary Care Setting
View DOI Record
View the PubMed citation for Depression Screening Among African American Adults in the Primary Care Setting2879
Depression screening and management among adolescents in primary care: factors associated with best practice
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: OBJECTIVE: To compare depression identification and management perceptions and practices between professions and disciplines in primary care and examine factors that increase the likelihood of administering a standardized depression screening instrument, asking about patients' depressive symptoms, and using best practice when managing depressed adolescents. METHODS: Data came from an online survey of clinicians in Minnesota (20% response rate). Analyses involved bivariate tests and linear regressions. RESULTS: The analytic sample comprised 260 family medicine physicians, 127 pediatricians, 96 family nurse practitioners, and 54 pediatric nurse practitioners. Overall, few differences emerged between physicians and nurse practitioners or family and pediatric clinicians regarding addressing depression among adolescents. Two factors associated with administering a standardized instrument included having clear protocols for follow-up after depression screening and feeling better prepared to address depression among adolescents. CONCLUSIONS: Enhancing clinicians' competence to address depression and developing postscreening protocols could help providers implement universal screening in primary care.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Depression screening and management among adolescents in primary care: factors associated with best practice
View DOI Record
View the PubMed citation for Depression screening and management among adolescents in primary care: factors associated with best practice2880
Depression screening in a VA primary care clinic
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: In 1998 the U.S. Department of Veterans Affairs (VA) mandated annual depression screening at all VA primary care clinics. The VA Medical Center, New Orleans, implemented a four-item screening tool. The authors report on an evaluation of the screening program. Of 1,100 patients visiting the clinic during a one-month period, 1,068 (97 percent) were screened at that visit or at some point in the previous 12 months. Of the 70 patients who screened positive for depression, 50 (71 percent) were offered at least one treatment modality or psychiatric referral. The findings establish benchmarks for screening administration and for follow-through on positive screens. The authors describe features of the electronic medical record that contributed to the successful implementation of this best practice.
Topic(s):
HIT & Telehealth
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