Depression Treatment

An innovative method to guide clinical treatment of depression is now being tested in a mental and behavioral health care organization. Researchers believe the new protocols will aid primary care physicians assess and treat depression. 1

Clinical depression is a serious medical illness that affects how you feel, think and function. Depression is extremely common and may be one of the most undiagnosed illnesses in the U.S. With proper diagnosis and treatment, almost all people suffering the symptoms of depression can be cured or effectively treated. 2

Overall, persons with depression had statistically significant problems in all four domains of primary care (8/10 indicators total). However, patterns differed substantially based on depression treatment status. Persons with untreated depression had difficulties in access (3/3 measures) and comprehensiveness of care (5/5 measures) but not with coordination (0/1 measure) and continuity (0/1 measures). In contrast, persons with depression who received specialty treatment had more difficulties in coordination (1/1 measures) and continuity (1/1 measures) of primary care. Persons treated for depression in primary care reported the fewest difficulties in any of the four domains of primary care (0/10 measures). 3

The study was the largest ever on the treatment of major depressive disorder and is considered a benchmark in the field of depression research. The six-year, $33 million study initially included more than 4,000 patients from clinics across the country. 4

Depression treatment by drugs and medicines is one of the most preferred methods and many people start feeling good effects of medicine during the first few weeks itself. Consistent ingestion of drugs for about 6 months will result in a remarkable improvement in the health of the affected patient. You may need to consult your physician every fortnight; this is just to let them know your mind and health. During further treatment, you will also visit your doctor every alternate month. If you have any serious side effects, inform your physician immediately and seek more inputs on the prescription. 5

Collaborative care resulted in more rapid improvement in depression symptomatology, and a more rapid and sustained improvement in mental health status compared to the more standard model. Mounting evidence indicates that collaboration between primary care providers and mental health specialists can improve depression treatment and supports the necessary changes in clinic structure and incentives. 6

The word ?depression? is used in many different ways to cover a range of feelings that people describe as depression. Depression ranges from feelings of sadness or unhappiness, to finding it difficult to get out of bed, to a group of mental illnesses known as clinical depression where in extreme circumstances a person may feel that life is no longer worth living. Frequently, feelings of sadness soon pass but sometimes these feelings persist and become disruptive to everyday life, making it increasingly difficult to cope. It is important to know that whatever the causes and symptoms of depression, treatment is very effective. 7

The broadcast does not list the cost of this experimental treatment, but notes that this procedure is currently being studied in a very select group of patients. However, if the story is promoted as a potential treatment, an estimate of the time and energy involved in the operation could be noted. The procedure is FDA approved for other conditions, but its use for depression treatment is considered 'off-label'; though, it is being studied for this and other psychiatric conditions (e.g. The story could mention is the procedure is covered by health insurance for people with intractable depression. 8

Using a nationally representative survey, this study seeks to better understand the relationship between depression and medical treatment by examining the association of depression with each the four key constructs of primary care. Results are examined by whether individuals received treatment for depression, and if so, whether that therapy was provided in primary care or a specialty mental health setting. The goal is to better disentangle the impact of depressive symptoms and treatment of those symptoms on use of medical services. 9

All patients taking antidepressants should be watched closely for signs that their condition is getting worse or that they are becoming suicidal, especially when they first start therapy, or when their dose is increased or decreased. Patients should also be watched for becoming agitated, irritable, hostile, aggressive, impulsive, or restless. Such symptoms should be reported to the patient?s doctor right away. 10

Anxiety is a normal response to a stressful or challenging event. Some people experience anxiety as a motivator while many others typically become agitated, tense and distressed. The term ?anxiety? covers a range of feelings from a generalised sense of nervousness, to feelings of fearfulness accompanied by a lack of confidence, to a group of mental illnesses known as anxiety disorders that result in disabling feelings of continual dread and tension which significantly interfere with daily life. Panic attacks may occur that further increase the fear and make it very difficult to cope. It is important to know that whatever the causes and symptoms of anxiety, treatment is very effective. 11

The GIMC is organized into 4 firms,25 to which providers and their patient panels are assigned in an unsystematic manner. GIMC staff with independent patient panels during the study recruitment period (January 1998 until March 1999, with follow-up for an additional 9 months) included 19 attending physicians, 38 residents, 10 fellows, and 22 nurse practitioners. The clinic was supported by 1 full-time equivalent psychiatry resident, an attending psychiatrist who supervised the resident, clinical psychologists and interns, and 4 social workers and interns. Two of the 4 clinic firms were randomly assigned to the collaborative care intervention, and 2 to CL care. 12

In the current research project, all patients with depression at study sites will be included. The number of patients could reach 8,000, depending on how many are scheduled for treatment with Centerstone, a nonprofit provider of community-based behavioral health services that has partnered with Dr. Trivedi. Centerstone operates facilities in middle Tennessee and southern Indiana. 13

The survey asked respondents "During the past 12 months, have you seen or talked to any of the following health care providers about your own health…a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker?" A positive response to this question was used to indicate specialty mental health treatment (whether or not the patient also reported depression treatment in primary care). A separate question asked whether the respondent had talked to their regular medical provider about their depressive symptoms during the past 12 months. Persons who answered affirmatively to this second question but did not report specialty mental health use were coded as having received depression treatment in primary care; and those who responded negatively to both were considered untreated. 14

References

1. psychcentral.com
2. www.mental-health-matters.com
3. www.pubmedcentral.nih.gov
4. psychcentral.com
5. www.buzzle.com
6. www.pubmedcentral.nih.gov
7. www.unisanet.unisa.edu.au
8. www.healthnewsreview.org
9. www.pubmedcentral.nih.gov
10. www.stillhavesymptoms.com
11. www.unisanet.unisa.edu.au
12. www.pubmedcentral.nih.gov
13. www.sciencedaily.com
14. www.pubmedcentral.nih.gov