Collaborative Care Significantly Improves Depression Outcomes

An intervention of collaborative care providers could greatly improve symptoms of depression in adolescents, according to a recent study.

“Proven treatments are available, including medications and psychotherapy,” said Laura P. Richardson, MD, MPH, an author of the study, researcher at Seattle Children’s Research Institute Center for Child Health, Development, and Behavior, a professor of pediatrics at the University of Washington (UW) School of Medicine, and an associate investigator at Group Health Research Institute.

“But most American teens with depression don’t get any treatment for it. We want to change that,” she said.
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For the Reaching Out to Adolescents in Distress (ROAD) study, researchers of the joint Seattle Children’s-Group Health-UW monitored 101 depressed teenagers (ages 13 to 17) from 9 Group Health Medical Centers in Washington state who were randomly assigned collaborative care or the regular care they have received in the past.

The collaborative care group included a care manager in the office of the participants' primary care physicians who helped the patient and his or her parents make informed treatment decisions.

The care manager later treated the patient with cognitive behavioral therapy or worked with the primary care physician to choose an appropriate antidepressant medication.

In contrast, the group receiving regular care ascertained results of their depression screenings and could receive mental health services at Group Health.

After a 12-month period, those in the intervention group showed decreases in Child Depression Rating Scale–Revised scores (mean score 27.5) compared with a mean score of 34.6% in the control group, and were significantly more likely to achieve depression remission that controls (50.4% vs 20.7%, respectively).

For each participant, the cost of the intervention model was $1,403.

According to the researchers, some of the study’s limitations included a smaller-than-intended sample size, and then a further limited selection of English speakers who were primarily white and female from an individual care system located in the Pacific Northwest limited the ability to generalize.

-Michelle Canales

References:

Richardson LP, Ludman E, McCauley E, et al. Collaborative Care for Adolescents With Depression in Primary Care. JAMA. 2014 August [epub ahead of print] doi:10.1001/jama.2014.9259.

Group Health Research Institute. Collaborative care improves depression in teens. August 26, 2014. www.grouphealthresearch.org/news-and-events/newsrel/2014/140826.html. Accessed August 27, 2014.