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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).
11202 Results
8801
Screening for depression and high utilization of health care resources among patients in primary care
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: The study aims to evaluate the prevalence of depression and the severity of depressive symptoms among primary care patients, who are high utilizers (HU) of health care resources. A cross-sectional, two-stage design was applied to screen for depression using the Brief Psychiatric Health Questionnaire and the Diagnostic Expert System for Psychiatric Disorders. A total of 38 primary care physicians accredited to practice in Berlin and Potsdam in Germany participated in the study. A total of 1,775 patients participated, 507 were identified as HU, 182 (36%) of these were depressed compared to 81 (11%) of the typical utilizers (p < 0.001). The depression score was higher and acute suicidality was more prevalent in HU than in typical utilizers (p < 0.001). Our results suggest that HU represent a population with a high prevalence of depression in primary care and should be considered for routine depression screening.
Topic(s):
Financing & Sustainability
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View the DOI record for Screening for depression and high utilization of health care resources among patients in primary care
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View the PubMed citation for Screening for depression and high utilization of health care resources among patients in primary care8803
Screening for depression in low-income elderly patients at the primary care level: use of the Patient Health Questionnaire-2
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: INTRODUCTION: Depression is one of the most common mental disorders and a leading cause of disability worldwide. It constitutes a serious public health problem, particularly among elderly individuals. Most depressed elderly patients are treated by primary care (PC) physicians. The "Patient Health Questionnaire" (PHQ-2) is an instrument used for the detection of depression in PC settings. OBJECTIVE: Evaluate the performance of the PHQ-2 in a low-income and uneducated elderly PC population. METHODS: A non-probabilistic population sample of 142 individuals was selected from the healthcare unit's users >== 60 years. Criterion validity was assessed by estimating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PHQ-2 in comparison with the structured interview using the DSM-IV. The estimates of sensitivity and specificity were obtained from varying cut-offs of the PHQ-2 score. A Receiver Operator Characteristic (ROC) curve was constructed and the area under the curve (AUC) was calculated. RESULTS: The group was predominantly female (73.9%), with low education level (mean 3 years of schooling). The mean age was 72.5 years old. The prevalence of depression was 26.1%. The best values of sensitivity (0.74), specificity (0.77), PPV (0.50) e NPV (0.90) were obtained with score equal to 1. The AUC was 0.77, indicating a modest performance of the test accuracy. CONCLUSION: The simplicity of the PHQ-2 is an advantage for its use in PC. The high NPV indicated that 90% of those who tested negative would not need additional tests. However, the low PPV indicated that the PHQ-2 is not sufficient to screen for depression. The application of the instrument could be the first step of the screening, that would include a second step to all those with positive tests formerly.
Topic(s):
Healthcare Disparities
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, Measures
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8805
Screening for depression in primary care: a Rasch analysis of the PHQ-9
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: Aims and method To explore the modern psychometric properties of the Patient Health Questionnaire (PHQ-9), we used the Rasch analysis in a sample of 767 primary care patients with depression. Results The analysis highlighted dependency issues between items 1 and 2 ('Little interest or pleasure in doing things' and 'Feeling down, depressed, or hopeless'), and items 3 and 4 ('Trouble falling or staying asleep, or sleeping too much' and 'Feeling tired or having little energy'). Items 1 and 2 displayed an over-discrimination, suggesting their potential redundancy within the complete item set. Clinical implications In its current format the PHQ-9 displays some problems with regard to its measurement structure among a sample of primary care patients. These problems can be addressed by removing potentially redundant items to deliver a stable screening tool. The results also lend support for the PHQ-2 to be used as a screening tool in a primary care setting.
Topic(s):
Measures
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View the PubMed citation for Screening for depression in primary care: a Rasch analysis of the PHQ-9
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View the DOI record for Screening for depression in primary care: a Rasch analysis of the PHQ-9
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View the PubMed citation for Screening for depression in primary care: a Rasch analysis of the PHQ-98806
Screening for depression in the primary care population
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Screening for depression in the primary care population
8808
Screening for illicit drug use
Type: Journal Article
Year: 2009
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Screening for illicit drug use
Export Citation: Download the RIS reference file for Screening for illicit drug use
8809
Screening for Mental Health Problems: Addressing the Base Rate Fallacy for a Sustainable Screening Program in Integrated Primary Care
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Healthcare Disparities
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8815
Screening for Parental Depression in Urban Primary Care Practices: A Mixed Methods Study
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: We sought to determine feasibility and acceptability of parental depression screening in urban pediatric practices. We recruited seven practices to participate. Patient Health Questionnaire-2, a validated two-item screening tool, was used to screen for depressive symptoms at 1-3 year old well visits. We conducted semi-structured interviews with clinicians to identify barriers and facilitators to screening. Of 8,621 eligible parents, 21.1% completed screening with site-specific rates ranging from 10.1% to 48.5%. Among those screened, 8.1% screened positive for depressive symptoms with site-specific rates ranging from 1.2% to 16.9%. Electronic alerts improved screening rates from 45 / month to 170 / month. Fifteen clinicians completed interviews and endorsed screening to provide help for families, build stronger ties with parents, and improve outcomes for children. However, insufficient time, need to complete activities with higher priority, lack of mental health availability, few resources for parents with limited English proficiency, and discomfort addressing depression were thought to limit screening.
Topic(s):
Healthcare Disparities
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, Measures
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Reference Links: View the PubMed citation for Screening for Parental Depression in Urban Primary Care Practices: A Mixed Methods Study
8819
Screening for postnatal depression in primary care: Cost effectiveness analysis
Type: Journal Article
Year: 2009
Publication Place: England
Abstract: OBJECTIVE: To evaluate the cost effectiveness of routine screening for postnatal depression in primary care. DESIGN: Cost effectiveness analysis with a decision model of alternative methods of screening for depression, including standardised postnatal depression and generic depression instruments. The performance of screening instruments was derived from a systematic review and bivariate meta-analysis at a range of instrument cut points; estimates of other relevant parameters were derived from literature sources and relevant databases. A decision tree considered the full treatment pathway from the possible onset of postnatal depression through identification, treatment, and possible relapse. SETTING: Primary care. PARTICIPANTS: A hypothetical population of women assessed for postnatal depression either via routine care only or supplemented by use of formal identification methods six weeks postnatally, as recommended in recent guidelines. MAIN OUTCOME MEASURES: Costs expressed in 2006-7 prices and impact on health outcomes expressed in terms of quality adjusted life years (QALYs). The time horizon of the analysis was one year. RESULTS: The routine application of either postnatal or general depression questionnaires did not seem to be cost effective compared with routine care only. The Edinburgh postnatal depression scale (at a cut point of 16) had an incremental cost effectiveness ratio (ICER) of pound 41,103 (euro 45,398, $67,130) per QALY compared with routine care only. The ICER for all other strategies ranged from pound 49,928 to pound 272,463 per QALY versus routine care only, while the probability that no formal identification strategy was cost effective was 88% (59%) at a cost effectiveness threshold of pound 20,000 ( pound 30,000) per QALY. While sensitivity analysis indicated that the cost of managing incorrectly identified depression (false positive result) was an important driver of the model, formal identification approaches did not seem to be cost effective at any feasible estimate of this cost. CONCLUSIONS: Formal identification methods for postnatal depression do not seem to represent value for money for the NHS. The major determinant of cost effectiveness seems to be the potential additional costs of managing women incorrectly diagnosed as depressed. Formal identification methods for postnatal depression do not currently satisfy the National Screening Committee's criteria for the adoption of a screening strategy as part of national health policy.
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for Screening for postnatal depression in primary care: Cost effectiveness analysis
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View the PubMed citation for Screening for postnatal depression in primary care: Cost effectiveness analysis8820
Screening for postpartum depression at well-child visits: is once enough during the first 6 months of life?
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: OBJECTIVE: Screening for maternal depression is gaining acceptance as a standard component of well-child care. We tested the feasibility of this policy and determined the prevalence and incidence of maternal depression at well-child visits during the first 6 months of life. METHODS: Providers in an adolescent-oriented maternity program were cued electronically, when they opened the electronic medical records of 0- to 6-month-old infants to conduct well-child visits, to ask the mothers to complete the Edinburgh Postpartum Depression Scale. Incident cases represented mothers who crossed the referral threshold (score of > or =10) after the first screening. RESULTS: Mothers usually brought their infants to the clinic, and none refused screening. Providers could act on 99% of the 418 screening cues; they administered the Edinburgh Postpartum Depression Scale 98% of the time and always referred mothers with scores of > or =10. Overall, 20% of the mothers scored > or =10. Scores were unstable at or =10 decreased from 16.5% at 2 months to 10.3% and 5.7%, respectively, at 4 months. Prevalence increased to 18.5% at the 6-month visit, and incidence decreased to 1.9%. Repeat screening detected only 2 mothers (5.7%) with scores of > or =10. CONCLUSIONS: Electronic cueing improved compliance with the detection and referral phases of screening for maternal depression at well-child visits. Screening 2 months after delivery detects most mothers who become depressed during the first 6 postpartum months, and screening at the 6-month well-child visit is preferable to screening at the 4-month visit.
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Screening for postpartum depression at well-child visits: is once enough during the first 6 months of life?
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View the PubMed citation for Screening for postpartum depression at well-child visits: is once enough during the first 6 months of life?