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Brief Reports   |    
A Collaborative Care Approach to Depression Treatment for Asian Americans
Anna D. H. Ratzliff, M.D., Ph.D.; Karen Ni, M.D.; Ya-Fen Chan, Ph.D.; Mijung Park, Ph.D., R.N.; Jürgen Unützer, M.D., M.P.H.
Psychiatric Services 2013; doi: 10.1176/appi.ps.001742012
View Author and Article Information

The authors are affiliated with the Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 N.E. Pacific St., Seattle, WA 98195-6560 (e-mail: annar22@uw.edu).

Copyright © 2013 by the American Psychiatric Association


Objective  This study examined effectiveness of collaborative care for depression among Asians treated either at a community health center that focuses on Asians (culturally sensitive clinic) or at general community health centers and among a matched population of whites treated at the same general community clinics.

Methods  For 345 participants in a statewide collaborative care program, use of psychotropic medications, primary care visits with depression care managers, and depression severity (as measured with the nine-item Patient Health Questionnaire) were tracked at baseline and 16 weeks.

Results  After adjustment for differences in baseline demographic characteristics, all three groups had similar treatment process and depression outcomes. Asian patients served at the culturally sensitive clinic (N=129) were less likely than Asians (N=72) and whites (N=144) treated in general community health clinics to be prescribed psychotropic medications.

Conclusions  Collaborative care for depression showed similar response rates among all three groups.

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Anchor for Jump
Table 1Baseline sample characteristics of Asians and a matched group of whites treated for depression at community health centers, by clinic type
Table Footer Note

a With cutoffs defined by Kroenke and colleagues (10) for the nine-item Patient Health Questionnaire (PHQ-9), scores ≥10 and <20 indicate moderately severe depression and scores ≥20 indicate severe depression.

Table Footer Note

b A total of 31 patients did not provide information on social support problems, including four Asian patients from the culturally sensitive clinic, 13 Asian patients from general clinics, and 14 white patients from general clinics.

Table Footer Note

c A total of 26 patients did not provide information on housing problems, including three Asian patients from the culturally sensitive clinic, 11 Asian patients from general clinics, and 12 white patients from general clinics.

Anchor for Jump
Table 2Treatment process and depression outcomes for Asians and a matched group of whites, by clinic typea
Table Footer Note

a Estimates were adjusted for age, gender, baseline nine-item Patient Health Questionnaire score, anxiety disorder, suicidal thoughts, problems with social support, problems with housing, and length of treatment in the model.

Table Footer Note

b Defined as achieving a score <10 or a ≥50% reduction from the baseline score on the nine-item Patient Health Questionnaire



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