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Psychiatr Serv. 2007 Aug;58(8):1065-72.

A pilot study of telephone care management and structured disease self-management groups for chronic depression.

Author information

1
Group Health Center for Health Studies, 1730 Minor Avenue, Seattle, WA 98101, USA. ludman.e@ghc.org

Abstract

OBJECTIVE:

The authors developed, implemented, and pilot-tested intervention programs to provide effective care for chronic or recurrent depression.

METHODS:

A total of 104 patients with chronic or recurrent depression were randomly assigned to one of four groups: continued usual behavioral health care, usual care plus telephone monitoring and care management by a care manager, usual care plus care management plus a peer-led chronic-disease self-management group program, or usual care plus care management plus a professionally led depression psychotherapy group. Outcomes in intent-to-treat analyses were assessed at three, six, nine, and 12 months and included treatment participation rates, Hopkins Symptom Checklist depression scale scores, major depression (Structured Clinical Interview for DSM-IV), Patient-Rated Global Improvement ratings, treatment satisfaction, and adequacy of medication.

RESULTS:

Participation in care management was high in the three intervention groups. Close to 60% of participants invited to both group interventions attended at least an initial meeting, but a greater number assigned to the care management plus the professionally led group continued participation through the 12-month period. The sample was too small to reliably detect small or moderate differences in clinical outcomes, but various measures consistently favored the care management plus professionally led group.

CONCLUSIONS:

It is feasible to direct additional intervention services to patients with persistent or recurring depression. A larger trial of organized self-management support for chronic depression will be necessary for a definitive evaluation of program effectiveness.

PMID:
17664517
DOI:
10.1176/ps.2007.58.8.1065
[Indexed for MEDLINE]
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