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Articles   |    
Impact of a Culturally Focused Psychiatric Consultation on Depressive Symptoms Among Latinos in Primary Care
C. Andres Bedoya, Ph.D.; Lara Traeger, Ph.D.; Nhi-Ha T. Trinh, M.D., M.P.H.; Trina E. Chang, M.D., M.P.H.; Charlotte D. Brill, B.A.; Katherine Hails, B.A.; Patrick N. Hagan, B.A.; Katherine Flaherty, Sc.D.; Albert Yeung, M.D., Sc.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300088
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Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: abedoya@mgh.harvard.edu). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.

Copyright © 2014 by the American Psychiatric Association

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Abstract

Objective  A culturally focused psychiatric (CFP) consultation service was implemented to increase engagement in mental health care and reduce depressive symptoms among adult Latino primary care patients. The aim of this study was to assess preliminary efficacy of the CFP consultation service to reduce depressive symptoms.

Methods  In a randomized controlled study, primary care clinics were randomly selected to provide either the two-session CFP intervention or enhanced usual care. For CFP intervention participants, study clinicians (psychologists or psychiatrists) provided a psychiatric assessment, psychoeducation, cognitive-behavioral tools, and tailored treatment recommendations; primary care providers were provided a consultation summary. Depressive symptoms (as measured by the Quick Inventory of Depressive Symptomatology–Self Rated [QIDS-SR]) were assessed at baseline and six-month follow-up. Multiple regression analysis was conducted to evaluate whether CFP intervention participants showed greater improvement in depressive symptoms at follow-up, with control for baseline depression, clinic site, and significant covariates.

Results  Participants (N=118) were primarily Spanish-monolingual speakers (64%). Although depressive symptoms remained in the moderate range for both groups from baseline to six months, symptom reduction was greater among CFP intervention participants (mean±SD change in QIDS-SR score=3.46±5.48) than those in usual care (change=.09±4.43). The final multiple regression model indicated that participation in the CFP intervention predicted lower depressive symptoms at follow-up (unstandardized beta=−3.09, p=.008), independent of baseline depressive symptoms, clinic site, age, gender, and employment status.

Conclusions  Results suggest that Latinos experiencing depressive symptoms may benefit from a short-term CFP consultation. Findings also support the integration of psychiatric interventions for Latinos in the primary care setting.

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