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Yang Y, Hou DL. Association of depressive symptoms and dementia among middle-aged and elderly community-dwelling adults: Results from the China Health and Retirement Longitudinal Study (CHARLS). Acta Psychol (Amst) 2024; 243:104158. [PMID: 38277731 DOI: 10.1016/j.actpsy.2024.104158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND There has been a long-standing debate on whether depressive symptoms are associated with dementia. The aim of this study was to examine whether depressive symptoms were associated with a high risk for dementia in Chinese adults. METHODS A total of 13,426 Chinese adults (≥45 years old) from the China Health and Retirement Longitudinal Study (CHARLS) baseline were selected for analysis. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale (CESD-10). Dementia was assessed by the Community Screening Instrument for Dementia (CSI-D). When using linear regression for sensitivity analysis, there is still a correlation between depressive symptoms and dementia. RESULTS Of the 13,426 respondents, the mean (SD) age was 60 (10) years old. The prevalence of depressive symptoms and dementia among participants was 38 % (n = 945) and 18.3 % (n = 2457), respectively. After fully adjusted for demographic factors, health behavior and psychological factors, living and working conditions factors, social network factors, and social policy factors, the cross-sectional analyses showed that depressive symptoms had an increased risk of dementia (OR = 1.390, 95%CI: 1.253-1.543), compared with those without depressive symptoms. In addition, sensitivity analyses of the association between depressive symptoms and dementia were unchanged when reanalyzing using linear regression. CONCLUSIONS In this study, depression symptoms may be associated with dementia. Regardless of whether depressive symptoms acts as a dementia risk factor or an early symptom, monitoring depressive symptoms is crucial to watch for potential dementia onset.
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Affiliation(s)
- Yang Yang
- Jinan Third People's Hospital, Jinan, China
| | - Da Long Hou
- Shandong Provincial Third Hospital, Shandong University, Jinan, China.
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Chen X. Effectiveness of cognitive stimulation therapy (CST) on cognition, quality of life and neuropsychiatric symptoms for patients living with dementia: A meta-analysis. Geriatr Nurs 2022; 47:201-210. [PMID: 35940038 DOI: 10.1016/j.gerinurse.2022.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Many scholars have explored the effect of cognitive stimulation therapy (CST) on dementia patients, however, due to different experimental designs and insufficient sample sizes, research results are inconsistent. Furthermore, there is a scarcity of high-quality quantitative results. OBJECTIVE To assess the effectiveness of CST for improving cognition, quality of life (QoL) and neuropsychiatric symptoms in people with dementia (PwD). METHODS Chinese and English databases were searched for randomized controlled trials (RCTs) between establishment of and April 2022, with another search done in May 2022. Finally, 10 studies on the application of CST in PwD for improving cognition, QoL, behavior, language and activities of daily living were reviewed. RESULTS Based on the results of the 10 RCTs, CST significantly improved cognitive performance (MMSE: WMD = 1.98, 95% CI: 1.24-2.72, P<0.01), QoL (WMD = 3.12, 95% CI: 2.52-3.72, P<0.01), language (NLT: WMD = 2.71, 95% CI: 1.07-4.35, P<0.01) and activities of daily living (DAD: WMD = 7.27, 95% CI: 0.97-13.56, P<0.01) in PwD. However, no significant improvements in ADAS-Cog (WMD = 0.55, 95% CI: -3.04-4.14, P = 0.76), depression (SMD = -0.12,95% CI: -0.29-0.04, P = 0.15), anxiety (RAID: WMD = -1.05, 95% CI: -3.85-1.75, P = 0.46) or neuropsychiatric symptoms (NPI: WMD = 0.23, 95% CI: -2.62-3.07, P = 0.88) were found. CONCLUSION CST improved the cognitive ability, QoL, language and activities of daily living of PwD. However, the effect of neuropsychiatric symptoms on PwD requires further exploration.
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Affiliation(s)
- Xue Chen
- China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
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Marabini L, Pazzaglini C, Bonazzi S, Guasti P, Guerra G, Zurlo A, Zuliani G, Brombo G. Depressive symptoms and cognitive/functional status in a sample of elderly subjects referring to a memory clinic. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jamieson H, Abey-Nesbit R, Nishtala PS, Allore H, Han L, Deely JM, Pickering JW. Predictors of Residential Care Admission in Community-Dwelling Older People With Dementia. J Am Med Dir Assoc 2020; 21:1665-1670. [PMID: 32646821 PMCID: PMC7641960 DOI: 10.1016/j.jamda.2020.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objectives of this study were to identify variables associated with dementia and entry into aged residential care (ARC) and derive and validate a risk prediction model for dementia and entry into ARC. DESIGN This was an observational study of prospectively collected Home Care International Residential Assessment Instrument (interRAI-HC) assessment data. SETTING AND PARTICIPANTS Participants included all people age ≥65 years who had completed an interRAI-HC assessment between July 1, 2012 and June 30, 2018. Exclusion criteria included death or entry into ARC within 30 days of assessment and not living at home at the time of the assessment. MEASURES InterRAI data from 94,202 older New Zealanders were evaluated for presence or absence of dementia. A multivariable competing-risks model for entry into ARC with death as the competing event was used to estimate subdistribution hazard ratios (SHR). RESULTS In total, there were 18,672 (19.8%) persons with dementia (PWD). PWD were almost twice as likely to enter ARC as persons without dementia [42.8% vs 25.3%; difference 17.5% (95% confidence interval 16.7%‒18.2%)]. PWD at highest risk of entering ARC were those where there was a desire to live elsewhere (SHR 1.44), depression (indicated, SHR 1.15), poor cognitive performance (Cognitive Performance Scale minimal SHR 1.32 and severe plus SHR 1.91), and wandering (SHR 1.19). Factors associated with reduced risks of PWD entering ARC were living with a child or relative, alcohol consumption, and comorbidities. CONCLUSIONS AND IMPLICATIONS A desire to live elsewhere, social isolation, independent activities of daily living, and depression were independently associated with entry into ARC. Supporting caregivers may improve outcomes for PWD that delay entry into ARC. Future revisions of the interRAI questionnaire could provide more insight on this matter.
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Affiliation(s)
- Hamish Jamieson
- Department of Medicine, University of Otago, Christchurch, New Zealand; Burwood Hospital, Christchurch, New Zealand.
| | | | - Prasad S Nishtala
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Heather Allore
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA; Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, USA
| | - Ling Han
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, CT, USA
| | - Joanne M Deely
- Canterbury District Health Board, Christchurch, New Zealand; Research Management Office, Lincoln University, Lincoln, New Zealand
| | - John W Pickering
- Department of Medicine, University of Otago, Christchurch, New Zealand
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Iyer S, Lozo S, Botros C, Wang C, Warren A, Sand P, Tomezsko J, Botros S, Gafni-Kane A, Sasso K, Goldberg RP. Cognitive changes in women starting anticholinergic medications for overactive bladder: a prospective study. Int Urogynecol J 2019; 31:2653-2660. [PMID: 31813036 DOI: 10.1007/s00192-019-04140-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 09/26/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To assess cognitive changes in women 12 months after starting anticholinergic medications for overactive bladder syndrome (OAB). METHODS We present a prospective cohort study assessing changes in cognition in women seen in a referral urogynecology practice. We compared women who started anticholinergic OAB medications with women not on anticholinergic OAB medications. The primary outcome was change over time on the Montreal Cognitive Assessment (MOCA) screening score. At enrollment, women completed a baseline MOCA screening, a Geriatric Depression Screen (GDS), and an assessment of medications to create an anticholinergic burden score (ACB). At 3, 6, 9, and 12 months after enrollment women were administered the MOCA, GDS, and a review of their medications and medical problems. Statistical analysis was performed using a linear mixed effects model taking into account correlated error terms given multiple MOCA assessments at various time points per patient. RESULTS A total of 106 women were enrolled, 60 in the OAB medication group and 46 in the control (non-OAB medication) group. The mean age was 77 years, 93% of women were Caucasian, and 98% completed high school, with no difference between groups. Over time there was no difference in change of MOCA score between the OAB and control groups when controlling for age, GDS score, and ACB score (p = 0.78). This association did not change when women with a neurological diagnosis were excluded (n = 6). On average MOCA scores for the OAB group increased by 0.76 over 12 months and the control group increased 0.39, with no difference between the groups (p = 0.53). CONCLUSIONS We found no changes in MOCA scores between OAB medication and control groups after controlling for age, depression, and polypharmacy after 12 months of follow-up.
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Affiliation(s)
- Shilpa Iyer
- Department of Obstetrics and Gynecology, Section of Female Pelvic Medicine and Reconstructive Surgery, The University of Chicago, 5841 South Maryland Avenue, MC 2050, Chicago, IL, 60637-1470, USA.
| | - Svjetlana Lozo
- Department of Obstetrics and Gynecology, Section of Urogynecology, NorthShore University Health Systems, Affiliated with The University of Chicago, Skokie, IL, USA
| | | | - Chi Wang
- Research Institute, NorthShore University Health Systems, Evanston, IL, USA
| | - Alexandra Warren
- Central Michigan University College of Medicine, Mount Pleasant, MI, USA
| | - Peter Sand
- Department of Obstetrics and Gynecology, Section of Urogynecology, NorthShore University Health Systems, Affiliated with The University of Chicago, Skokie, IL, USA
| | | | - Sylvia Botros
- Department of Urology, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Adam Gafni-Kane
- Department of Obstetrics and Gynecology, Section of Urogynecology, NorthShore University Health Systems, Affiliated with The University of Chicago, Skokie, IL, USA
| | - Karen Sasso
- Department of Obstetrics and Gynecology, Section of Urogynecology, NorthShore University Health Systems, Affiliated with The University of Chicago, Skokie, IL, USA
| | - Roger P Goldberg
- Department of Obstetrics and Gynecology, Section of Urogynecology, NorthShore University Health Systems, Affiliated with The University of Chicago, Skokie, IL, USA
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Bryan JL, Asghar-Ali AA. Development and Dissemination of an Interprofessional Online Dementia Training Curriculum. J Am Geriatr Soc 2019; 68:192-197. [PMID: 31693177 DOI: 10.1111/jgs.16240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/26/2019] [Accepted: 10/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Despite the growing number of individuals with dementia, clinicians skilled in caring for people with dementia, especially in rural areas, are lacking. The Program for Advancing Cognitive Disorders Education for Rural Staff (PACERS) was designed to improve clinician competency and comfort when caring for individuals with dementia. Based on an interprofessional needs assessment, six 1-hour training modules were created: (1) Dementia and Delirium, (2) Identifying and Assessing for Dementia, (3) Treating Dementia: Case Studies, (4) Normal Cognitive Aging and Dementia Caregiving, (5) Addressing Decision Making and Safety in Dementia, and (6) Dementia and Driving. Each module is available for free on the Department of Veterans Affairs Talent Management System (TMS) for employees and the free TrainingFinder Real-time Affiliate Integrated Network (TRAIN) platform for clinicians in the community. One continuing education unit is earned upon completion of each module. DESIGN Posttest. SETTING Online training at VA TMS and TRAIN. PARTICIPANTS To date, more than 3000 modules have been completed by interprofessional healthcare learners (eg, nurses, physicians, psychologists, and social workers). MEASUREMENTS Satisfaction, perceived utility of training, knowledge, skills, and attitudes were assessed. RESULTS The learners reported high satisfaction (mean [M] > 4) and ability to apply the knowledge and skills learned from the module to their job (M > 4) on a Likert scale (1 = Strongly disagree to 5 = Strongly agree). CONCLUSION Learners also reported perceived impact on both direct patient care (eg, ability to provide education and support to individuals with dementia and their caregivers) and system-level care (eg, more appropriate referrals). Given the number of users and their evaluation data, PACERS can serve as a model curriculum for online interprofessional dementia training. J Am Geriatr Soc 68:192-197, 2019.
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Affiliation(s)
- Jennifer L Bryan
- VA South Central Mental Illness Research, Education and Clinical Center (MIRECC), Houston, Texas.,VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas
| | - Ali Abbas Asghar-Ali
- VA South Central Mental Illness Research, Education and Clinical Center (MIRECC), Houston, Texas.,VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas
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Effects of an Exercise and Mental Activity Program for People With Dementia and Their Care Partners. J Aging Phys Act 2019; 27:276-283. [DOI: 10.1123/japa.2017-0300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Yang F, Ran M, Luo W. Depression of persons with dementia and family caregiver burden: Finding positives in caregiving as a moderator. Geriatr Gerontol Int 2019; 19:414-418. [PMID: 30773779 DOI: 10.1111/ggi.13632] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/23/2018] [Accepted: 01/19/2019] [Indexed: 11/26/2022]
Abstract
AIM The present study examined the association between depression of persons with dementia and family caregiver burden, as well as whether the association depended on the level of caregivers' ability to find positives in caregiving. METHODS Based on the medical records of a local mental health hospital and the statistics of an epidemiological survey, this cross-sectional study included 157 major family caregivers of non-institutionalized dementia patients in the rural sector of Western China's Sichuan Province. They responded to the Cornell Scale for Depression in Dementia, a short version of the Zarit Burden Interview, a subscale of a caregiver meaning scale and demographic questions. RESULTS Controlling for the demographic variables of the caregivers, the present study found that dementia patients' depression level was significantly associated with caregiver burden (P < 0.001), and the caregivers' levels of finding positives in caregiving significantly moderated the association (P < 0.05). Furthermore, the positive correlation between dementia patients' depression and caregiver burden was weaker among the family caregivers with a high level of finding positives in caregiving, compared with those with a low level of finding positives in caregiving. CONCLUSIONS This research suggests the importance of facilitating family caregivers of dementia patients to find positives in caregiving. It provides initial data for the development of dementia caregiver burden interventions that are based on the understanding of the deep meaning of dementia caregiving. Geriatr Gerontol Int 2019; 19: 414-418.
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Affiliation(s)
- Fan Yang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Maosheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Wei Luo
- Xinjin No.2 People's Hospital, Chengdu, China
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10
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Annear MJ. Knowledge of Dementia Among the Australian Health Workforce: A National Online Survey. J Appl Gerontol 2018; 39:62-73. [DOI: 10.1177/0733464817752085] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dementia is a leading cause of death and disability in Australia. This research evaluated dementia knowledge and educational needs among the Australian health workforce. An online version of the validated Dementia Knowledge Assessment Scale (DKAS) was administered with a random sample of 234 health professionals across eight Australian states. Respondents provided additional self-report data concerning dementia experiences, educational needs, and demographic information. Dementia knowledge deficiencies were identified concerning risk factors, prevalent typologies of the condition, and cognitive symptoms. Prior university education and dementia-specific training were predictive of significantly higher knowledge scores. Self-reported dementia education needs included nonpharmaceutical interventions for the behavioral and psychological symptoms and best-evidence care provision. Knowledge deficiencies among health workers suggest patients with dementia may not be receiving consistent, best-evidence care in Australia. The research findings will support the development of a targeted online dementia education intervention that aims to improve health worker knowledge and patient care.
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Annear MJ, Toye C, Elliott KEJ, McInerney F, Eccleston C, Robinson A. Dementia knowledge assessment scale (DKAS): confirmatory factor analysis and comparative subscale scores among an international cohort. BMC Geriatr 2017; 17:168. [PMID: 28760154 PMCID: PMC5537989 DOI: 10.1186/s12877-017-0552-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 07/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background Dementia is a life-limiting condition that is increasing in global prevalence in line with population ageing. In this context, it is necessary to accurately measure dementia knowledge across a spectrum of health professional and lay populations with the aim of informing targeted educational interventions and improving literacy, care, and support. Building on prior exploratory analysis, which informed the development of the preliminarily valid and reliable version of the Dementia Knowledge Assessment Scale (DKAS), a Confirmatory Factor Analysis (CFA) was performed to affirm construct validity and proposed subscales to further increase the measure’s utility for academics and educators. Methods A large, de novo sample of 3649 volunteer respondents to a dementia-related online course was recruited to evaluate the performance of the DKAS and its proposed subscales. Respondents represented diverse cohorts, including health professionals, students, and members of the general public. Analyses included CFA (using structural equation modelling), measures of internal consistency (α), and non-parametric tests of subscale correlation (Spearman Correlation) and score differences between cohorts (Kruskal-Wallis one-way analysis of variance). Results Findings of the CFA supported a 25-item, four-factor model for the DKAS with two items removed due to poor performance and one item moved between factors. The resultant model exhibited good reliability (α = .85; ωh = .87; overall scale), with acceptable subscale internal consistency (α ≥ .65; subscales). Subscales showed acceptable correlation without any indication of redundancy. Finally, total and DKAS subscale scores showed good discrimination between cohorts of respondents who would be anticipated to hold different levels of knowledge on the basis of education or experience related to dementia. Conclusion The DKAS has been confirmed as a reliable and valid measure of dementia knowledge for diverse populations that is capable of elucidating knowledge characteristics across four coherent domains: 1) Causes and Characteristics, 2) Communication and Behaviour, 3) Care Considerations, and 4) Risks and Health Promotion. Importantly, the four confirmed subscales clearly distinguish between groups who might be expected to hold differing levels of knowledge about dementia, allowing for a fine-grained level of detail to be established when evaluating baseline understanding or knowledge change associated with educational intervention.
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Affiliation(s)
- Michael J Annear
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia.
| | - Chris Toye
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia.,School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, WA, Australia
| | - Kate-Ellen J Elliott
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Frances McInerney
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Claire Eccleston
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia
| | - Andrew Robinson
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, TAS, Australia.,School of Health Sciences, University of Tasmania, Hobart, TAS, Australia
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Silverstone PH, Rittenbach K, Suen VYM, Moretzsohn A, Cribben I, Bercov M, Allen A, Pryce C, Hamza DM, Trew M. Depression Outcomes in Adults Attending Family Practice Were Not Improved by Screening, Stepped-Care, or Online CBT during a 12-Week Study when Compared to Controls in a Randomized Trial. Front Psychiatry 2017; 8:32. [PMID: 28373846 PMCID: PMC5357781 DOI: 10.3389/fpsyt.2017.00032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/15/2017] [Indexed: 11/13/2022] Open
Abstract
There is uncertainty regarding possible benefits of screening for depression in family practice, as well as the most effective treatment approach when depression is identified. Here, we examined whether screening patients for depression in primary care, and then treating them with different modalities, was better than treatment-as-usual (TAU) alone. Screening was carried out for depression using the 9-item Patient Health Questionnaire (PHQ-9), with a score of ≥10 indicating significant depressive symptoms. PHQ-9 scores were given to family physicians prior to patients being seen (except for the Control group). Patients (n = 1,489) were randomized to one of four groups. Group #1 were controls (n = 432) in which PHQ-9 was administered, but results were not shared. Group #2 was screening followed by TAU (n = 426). Group #3 was screening followed by both TAU and the opportunity to use an online cognitive behavioral therapy (CBT) treatment program (n = 440). Group #4 utilized an evidence-based Stepped-care pathway for depression (n = 191, note that this was not available at all clinics). Of the study sample 889 (60%) completed a second PHQ-9 rating at 12 weeks. There were no statistically significant differences in baseline PHQ-9 scores between these groups. Compared to baseline, mean PHQ-9 scores decreased significantly in the depressed patients over 12 weeks, but there were no statistically significant differences between any groups at 12 weeks. Thus, for those who were depressed at baseline Control group (Group #1) scores decreased from 15.3 ± 4.2 to 4.0 ± 2.6 (p < 0.001), Screening group (Group #2) scores decreased from 15.5 ± 3.9 to 4.6 ± 3.0 (p < 0.001), Online CBT group (Group #3) scores decreased from 15.4 ± 3.8 to 3.4 ± 2.7 (p < 0.01), and the Stepped-care pathway group (Group #4) scores decreased from 15.3 ± 3.6 to 5.4 ± 2.8 (p < 0.05). In conclusion, these findings from this controlled randomized study do not suggest that using depression screening tools in family practice improves outcomes. They also suggest that much of the depression seen in primary care spontaneously resolves and do not support suggestions that more complex treatment programs or pathways improve depression outcomes in primary care. Replication studies are required due to study limitations.
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Affiliation(s)
- Peter H Silverstone
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada; Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada; Department of Finance and Statistical Analysis, University of Alberta, Edmonton, AB, Canada
| | - Katherine Rittenbach
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Victoria Y M Suen
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | | | - Ivor Cribben
- Department of Finance and Statistical Analysis, University of Alberta , Edmonton, AB , Canada
| | - Marni Bercov
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Andrea Allen
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Catherine Pryce
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
| | - Deena M Hamza
- Department of Psychiatry, University of Alberta , Edmonton, AB , Canada
| | - Michael Trew
- Strategic Clinical Network for Addiction and Mental Health, Alberta Health Services , Edmonton, AB , Canada
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