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Clinical Trial
. 2002 Oct;37(5):1145-58.
doi: 10.1111/1475-6773.01086.

The effects of primary care depression treatment on patients' clinical status and employment

Affiliations
Clinical Trial

The effects of primary care depression treatment on patients' clinical status and employment

Michael Schoenbaum et al. Health Serv Res. 2002 Oct.

Abstract

Objective: To evaluate the effects of depression treatment in primary care on patients' clinical status and employment, over six months.

Data sources/study setting: Data are from a randomized controlled trial of quality improvement for depression that included 938 adults with depressive disorder in 46 managed primary care clinics in five states.

Study design: Observational analysis of the effects of evidence-based depression care over six months on health outcomes and employment. Selection into treatment is accounted for using instrumental variables techniques, with randomized assignment to the quality improvement intervention as the identifying instrument.

Data collection/extraction methods: Patient-reported clinical status, employment, health care use, and personal characteristics; health care use and costs from claims data.

Principal findings: At six months, patients with appropriate care, compared to those without it, had lower rates of depressive disorder (24 percent versus 70 percent), better mental health-related quality of life, and higher rates of employment (72 percent versus 53 percent), each p<.05.

Conclusions: Appropriate treatment for depression provided in community-based primary care substantially improves clinical and quality of life outcomes and employment.

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References

    1. American Psychiatric Association. “Practice Guidelines for Major Depressive Disorder in Adults.”. American Journal of Psychiatry. 1993;150:1–26. - PubMed
    1. Angrist JD, Imbens GW, Rubin DB. “Identification of Causal Effects Using Instrumental Variables.”. Journal of the American Statistical Association. 1996;91(434):444–55.
    1. Attikson CC, Zich JM. Depression in Primary Care: Screening and Detection. New York: Routledge; 1990.
    1. Berndt ER, Finkelstein SN, Greenberg PE, Howland RH, Keith A, Rush AJ, Russell J, Keller MB. “Workplace Performance Effects from Chronic Depression and its Treatment.”. Journal of Health Economics. 1998;17(5):511–35. - PubMed
    1. Bound J, Schoenbaum M, Stinebrickner T, Waidmann T. “The Dynamic Effects of Health on the Labor Force Transitions of Older Workers.”. Labour Economics. 1999;6(2):179–202.

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