Literature Collection

Despite increasing rates of co-morbid depression and obesity, few interventions target both conditions simultaneously, particularly in men. The SHED-IT: Recharge trial, conducted in 125 men with depressive symptoms and overweight or obesity, tested the efficacy of a gender-tailored eHealth program with integrated mental health support. The aims of this study were to examine the perceptions of men who received the SHED-IT: Recharge intervention in relation to recruitment, satisfaction with the program, and suggestions to improve the program. Individual semi-structured interviews were conducted in a random sub-sample, stratified by baseline depression and weight status (n = 19, mean (SD) age 49.6 years (11.6), PHQ-9 score 9.0 (3.7), BMI 32.5 kg/m(2) (4.6)). Transcripts were analyzed using an inductive process by an independent qualitative researcher. Four themes emerged, namely, (i) specific circumstances determined men's motivation to enroll, (ii) unique opportunity to implement sustained physical and mental health changes compared to previous experiences, (iii) salience of the program elements, and (iv) further opportunities that build accountability could help maintain focus. Gender-tailored, self-directed lifestyle interventions incorporating mental health support are acceptable and satisfying for men experiencing depressive symptoms. These findings provide important insights for future self-guided lifestyle interventions for men with poor physical and mental health.

The primary care office is an essential part of the mental health system. Overall, at least half of all visits to clinicians for mental health conditions are to primary care physicians. The collaborative care model, which integrates behavioral health services into the primary care office, has been shown to improve patient outcomes and is cost-effective. The five essential components of the collaborative care model include team-driven care, population-focused care, measurement-guided care, evidence-based care, and accountable care. To assist with counseling patients during office visits, multiple brief interventions have been created and/or adapted from longer interventions. Some of these tools include the Five As behavioral change model; the background, affect, troubling, handling, empathy (BATHE) technique; the feedback, responsibility, advice, menu of strategies, empathy, self-efficacy (FRAMES) model, and the stages of change model (ie, transtheoretical model). Use of brief interventions has been shown to result in modest improvements in mental health outcomes in the short-term. These interventions can be applied to patients with anxiety, depression, and substance use disorders.

OBJECTIVE: The goal was to examine psychiatric diagnosis rates among a national cohort of primary care patients with and without obesity. METHODS: The cohort was derived from national Veterans Health Administration data (women, N=342,262; men, N=4,524,787). Sex-stratified descriptive statistics characterized psychiatric diagnosis rates. Chi-square tests determined whether diagnosis rates differed by obesity status (α=0.001). RESULTS: Rates of any psychiatric diagnosis were higher among women than among men and among people with obesity versus without obesity (women, 53.9% vs. 50.4%; men, 37.9% vs. 35.2%). Depression and posttraumatic stress disorder diagnosis rates were higher for people with obesity, and substance use disorder diagnosis rates were lower for people with obesity. Anxiety diagnosis rates were slightly lower among women with obesity versus women without obesity. CONCLUSIONS: Programs simultaneously addressing weight management and mental health could address the psychiatric comorbidities observed among people with obesity. Women are most likely to need these services.