The TrueBlue Model of Collaborative Care Using Practice Nurses as Case Managers for Depression Alongside Diabetes or Heart Disease: A Randomised Trial.
The TrueBlue model of collaborative care using practice nurses as case managers for depression alongside diabetes or heart disease: a randomised trial.
Filed under: Depression Treatment
BMJ Open. 2013; 3(1):
Morgan MA, Coates MJ, Dunbar JA, Reddy P, Schlicht K, Fuller J
To determine the effectiveness of collaborative care in reducing depression in primary care patients with diabetes or heart disease using practice nurses as case managers.A two-arm open randomised cluster trial with wait-list control for 6 months. The intervention was followed over 12 months.Eleven Australian general practices, five randomly allocated to the intervention and six to the control.400 primary care patients (206 intervention, 194 control) with depression and type 2 diabetes, coronary heart disease or both.The practice nurse acted as a case manager identifying depression, reviewing pathology results, lifestyle risk factors and patient goals and priorities. Usual care continued in the controls.A five-point reduction in depression scores for patients with moderate-to-severe depression. Secondary outcome was improvements in physiological measures.Mean depression scores after 6 months of intervention for patients with moderate-to-severe depression decreased by 5.7±1.3 compared with 4.3±1.2 in control, a significant (p=0.012) difference. (The plus-minus is the 95% confidence range.) Intervention practices demonstrated adherence to treatment guidelines and intensification of treatment for depression, where exercise increased by 19%, referrals to exercise programmes by 16%, referrals to mental health workers (MHWs) by 7% and visits to MHWs by 17%. Control-practice exercise did not change, whereas referrals to exercise programmes dropped by 5% and visits to MHWs by 3%. Only referrals to MHW increased by 12%. Intervention improvements were sustained over 12 months, with a significant (p=0.015) decrease in 10-year cardiovascular disease risk from 27.4±3.4% to 24.8±3.8%. A review of patients indicated that the study’s safety protocols were followed.TrueBlue participants showed significantly improved depression and treatment intensification, sustained over 12 months of intervention and reduced 10-year cardiovascular disease risk. Collaborative care using practice nurses appears to be an effective primary care intervention.ACTRN12609000333213 (Australia and New Zealand Clinical Trials Registry).
HubMed – depression
Police officers: a high-risk group for the development of mental health disturbances? A cohort study.
Filed under: Depression Treatment
BMJ Open. 2013; 3(1):
van der Velden PG, Rademaker AR, Vermetten E, Portengen MA, Yzermans JC, Grievink L
Policing is generally considered a high-risk profession for the development of mental health problems, but this assumption lacks empirical evidence. Research question of the present study is to what extent mental health disturbances, such as (very) severe symptoms of anxiety, depression and hostility are more prevalent among police officers than among other occupational groups.Multicomparative cross-sectional study using the data of several cross-sectional and longitudinal studies in the Netherlands.Two samples of police officers (N=144 and 503), employees of banks (N=1113) and employees of banks who were robbed (N=144); employees of supermarkets (N=335), and a psychiatric hospital (N=219), employees of a governmental social welfare organisation (N=76), employees who followed a training based on rational-motive therapy to strengthen their assertiveness (N=710), soldiers before deployment (N=278) and before redeployment (N=236) and firefighters (N=123). The numbers refer to respondents with complete data. PRIMARY OUTCOMES: Prevalence of severe (subclinical level) and very severe symptoms (clinical level) were computed using the Dutch norm tables (80th percentile and 95th percentile, respectively) of the Symptom Check List Revised (SCL-90-R). All comparisons were controlled for age, gender and education.Multivariate logistic regression and analyses showed that the prevalence of clinical and subclinical levels of symptoms of anxiety, depression and hostility among police officers were not significantly higher than among comparison groups. The same pattern was found for the other SCL-90-R subscales.We found no indications that self-reported mental health disturbances were more prevalent among police officers than among groups of employees that are not considered high-risk groups, such as employees of banks, supermarkets, psychiatric hospital and soldiers before deployment.
HubMed – depression
Depression and anxiety issue information.
Filed under: Depression Treatment
Depress Anxiety. 2013 Feb; 30(2): NA
Experimental Depression Treatment Studied – Pills work for most, but sometimes that isn’t enough. Now, an experimental treatment for depression is going right into the brain.
Amoryn – (2 bottles)AMORYN chases your blues away by combining the wisdom of nature with the power of science. The main ingredient in AMORYN, hyperfor…
Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek their HelpThis book provides a comprehensive look at effective therapy for postpartum depression. Using a blend of professional objectivity,…
Postpartum Depression For DummiesIt’s a great blessing when a new mom with postpartum depression (PPD) is fortunate enough to be diagnosed early by a knowledgeable…
Find More Depression Treatment Information…