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Collaborative care, training boosts adolescent depression treatment in primary care clinics

A model program featuring primary care physicians, nurses, and mental health providers working collaboratively to bring best-practice depression treatments into primary care clinics significantly improves health outcomes, quality of life, and depression care for adolescents (age 13-21), research team led by a UCLA investigator reports in the Jan 19, 2005, edition of the Journal of the American Medical Association.

After recent controversies about the safety and effectiveness of adolescent depression treatments, the study results add to evidence that clinicians can effectively treat youth depression and offer an optimistic view for those suffering from this common and disabling condition.

The study is the first to evaluate a "collaborative care program" for adolescent depression in primary care clinics. This team-based approach strengthened partnerships between primary and specialty care, trained practice clinicians in depression evaluation and treatment, and used nurses and therapists in the clinics to provide depression care. To offer an evidence-based psychotherapy option, clinic therapists were trained in cognitive-behavior therapy, a type of psychotherapy for depression. Families and patients chose with their clinicians among possible treatment options, including cognitive-behavior therapy and medication. Collaborative care programs are widely recommended for improving management of chronic medical illnesses, but until this study had not been tested for adolescent depression.

Compared with adolescents who received standard treatment, patients offered the model program were significantly less likely to report severe depression (31 percent vs. 42 percent), reported fewer depressive symptoms, improved quality of life, and greater satisfaction with their mental health care. They also received more mental health care, particularly psychotherapy (32 percent vs. 21 percent). When offered a choice of treatments, there was a tendency to choose p
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Contact: Dan Page
dpage@mednet.ucla.edu
310-794-0777
University of California - Los Angeles
18-Jan-2005


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