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COLLABORATIVE CARE FOR PERINATAL DEPRESSION IN SOCIOECONOMICALLY DISADVANTAGED WOMEN: A RANDOMIZED TRIAL.
- Source :
-
Depression & Anxiety (1091-4269) . Nov2015, Vol. 32 Issue 11, p821-834. 14p. 2 Diagrams, 3 Charts, 1 Graph. - Publication Year :
- 2015
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Abstract
- <bold>Background: </bold>Both antenatal and postpartum depression have adverse, lasting effects on maternal and child well-being. Socioeconomically disadvantaged women are at increased risk for perinatal depression and have experienced difficulty accessing evidence-based depression care. The authors evaluated whether "MOMCare,"a culturally relevant, collaborative care intervention, providing a choice of brief interpersonal psychotherapy and/or antidepressants, is associated with improved quality of care and depressive outcomes compared to intensive public health Maternity Support Services (MSS-Plus).<bold>Methods: </bold>A randomized multisite controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System. From January 2010 to July 2012, pregnant women were recruited who met criteria for probable major depression and/or dysthymia, English-speaking, had telephone access, and ≥18 years old. The primary outcome was depression severity at 3-, 6-, 12-, 18-month postbaseline assessments; secondary outcomes included functional improvement, PTSD severity, depression response and remission, and quality of depression care.<bold>Results: </bold>All participants were on Medicaid and 27 years old on average; 58% were non-White; 71% were unmarried; and 65% had probable PTSD. From before birth to 18 months postbaseline, MOMCare (n = 83) compared to MSS-Plus participants (n = 85) attained significantly lower levels of depression severity (Wald's χ(2) = 6.09, df = 1, P = .01) and PTSD severity (Wald's χ(2) = 4.61, df = 1, P = .04), higher rates of depression remission (Wald's χ(2) = 3.67, df = 1, P = .05), and had a greater likelihood of receiving ≥4 mental health visits (Wald's χ(2) = 58.23, df = 1, P < .0001) and of adhering to antidepressants in the prior month (Wald's χ(2) = 10.00, df = 1, P < .01).<bold>Conclusion: </bold>Compared to MSS-Plus, MOMCare showed significant improvement in quality of care, depression severity, and remission rates from before birth to 18 months postbaseline for socioeconomically disadvantaged women. Findings suggest that evidence-based perinatal depression care can be integrated into the services of a county public health system in the United States.<bold>Clinical Trial Registration: </bold>ClinicalTrials.govNCT01045655. [ABSTRACT FROM AUTHOR]
- Subjects :
- *DEPRESSION in women
*PREGNANT women
*POSTPARTUM depression
*POOR women
*ANTIDEPRESSANTS
*INTERPERSONAL psychotherapy
*POST-traumatic stress disorder
*MENTAL health
*MENTAL depression
*THERAPEUTICS
*TREATMENT of post-traumatic stress disorder
*DYSTHYMIC disorder
*COMPARATIVE studies
*COOPERATIVENESS
*RESEARCH methodology
*MEDICAID
*MEDICAL cooperation
*HEALTH outcome assessment
*POVERTY
*PSYCHOTHERAPY
*RESEARCH
*RESEARCH funding
*EVALUATION research
*RANDOMIZED controlled trials
*AT-risk people
*BLIND experiment
TREATMENT of pregnancy complications
Subjects
Details
- Language :
- English
- ISSN :
- 10914269
- Volume :
- 32
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Depression & Anxiety (1091-4269)
- Publication Type :
- Academic Journal
- Accession number :
- 110653752
- Full Text :
- https://doi.org/10.1002/da.22405