Collaborative Care for Depressed Patients With Chronic Medical Conditions: A Randomized Trial in Puerto Rico

Vera, Mildred; Pérez-Pedrogo, Coralee; Huertas, Sarah Enid; Reyes-Rabanillo, Maria Leticia; Juarbe, Deborah; Huertas, Aracelis; Reyes‐Rodríguez, Mae Lynn; Chaplin, William F.

doi:10.1176/ps.2010.61.2.144

Cited by 45 publications

(29 citation statements)

References 35 publications

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“…This approach is consistent with a collaborative care model (combining evidence-based treatment and care management) and with the Latino cultural value of personalism. The collaborative model has been shown to overcome access barriers to mental health services in Latinos (Vera, Pérez-Pedrogo, Huertas, Reyes-Rabanillo, Juarbe at al., 2010). Personalism is a key cultural value in which Latinos promote close relationships, especially with those who demonstrate respect, caring, and well-meaning.…”

Section: Discussionmentioning

confidence: 99%

Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

Reyes‐Rodríguez

Baucom

Bulik

2014

Revista Mexicana de Trastornos Alimentarios

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Objective We describe cognitive-behavioral therapy for bulimia nervosa (CBT-BN) with a Latina woman that incorporates culturally relevant topics. Method A single case report of a 31-year-old monolingual Latina woman with BN describes the application of a couple-based intervention adjunctive to CBT-BN. Results The patient reported no binge and purge episodes by session 20 and remained symptom free until the end of treatment (session 26). Improvement was observed in the Eating Disorders Examination (EDE) comparing baseline (EDE=5.74) with post treatment (EDE=1.25). Conclusions The case illustrates how cultural adaptations such as including a family member, being flexible on topics and scheduling, and providing culturally relevant interventions can lead to successful completion of a course of therapy and facilitate ongoing interventions to ensure continued recovery.

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Section: Discussionmentioning

confidence: 99%

Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

Reyes‐Rodríguez

Baucom

Bulik

2014

Revista Mexicana de Trastornos Alimentarios

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“…(2008) found that modified cognitive behavioral therapy and interpersonal psychotherapy emphasizing cultural values (e.g., familismo ) were effective at reducing depressive symptoms in a Puerto Rican sample. Further, the ADA (2016) recommends collaborative care models, and in Puerto Rico, a collaborative model where physicians and mental health professionals worked together to coordinate antidepressant treatment and counseling provided better reduction of depressive symptoms than usual care (Vera et al, 2010). Still, any strategies for improving diabetes management and treating depression for older Puerto Ricans will only be successful to the extent that further erosion of the healthcare system on the island can be avoided.…”

Section: Discussionmentioning

confidence: 99%

The association between cognitive decline and incident depressive symptoms in a sample of older Puerto Rican adults with diabetes

Bell

Dávila

Clay

et al. 2017

Int. Psychogeriatr.

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Background Older Puerto Rican adults have particularly high risk of diabetes compared to the general U.S. population. Diabetes is associated with both higher depressive symptoms and cognitive decline, but less is known about the longitudinal relationship between cognitive decline and incident depressive symptoms in those with diabetes. The current study investigated the association between cognitive decline and incident depressive symptoms in older Puerto Rican adults with diabetes over a four-year period. Methods Households across Puerto Rico were visited to identify a population-based sample of adults age 60+ for the Puerto Rican Elderly: Health Conditions study (PREHCO); 680 participants with diabetes at baseline and no baseline cognitive impairment were included in analyses. Cognitive decline and depressive symptoms were measured using the Mini-Mental Cabán (MMC) and Geriatric Depression Scale (GDS), respectively. We examined predictors of incident depressive symptoms (GDS ≥ 5 at follow-up but not baseline) and cognitive decline using regression modeling. Results In a covariate-adjusted logistic regression model, cognitive decline, female gender, and greater diabetes-related complications were each significantly associated with increased odds of incident depressive symptoms (p<.05). In a multiple regression model adjusted for covariates, incident depressive symptoms and older age were associated with greater cognitive decline, and higher education was related to less cognitive decline (p<.05). Conclusions Incident depressive symptoms were more common for older Puerto Ricans with diabetes who also experienced cognitive decline. Efforts are needed to optimize diabetes management and monitor for depression and cognitive decline in this population.

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“…gov, ISRCTN) on collaborative care interventions for depression in medically ill patients yielded eight trials which were published in 2010 or later as well as 16 ongoing trials [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]. The completed trials comprise samples of patients with mixed medical conditions (n ¼ 2 [32,38]), diabetes (n ¼ 2 [36,37]), heart diseases (n ¼ 2 [25 && ,35]), epilepsy (n ¼ 1 [28]) and HIV (n ¼ 1 [31 & ]) (Table 1). Two recent trials investigated the effects of collaborative care in patients with mixed medical illnesses.…”

Section: Evidence From Recent Randomized Controlled Clinical Trialsmentioning

confidence: 99%

“…A study on 179 depressed patients with chronic general medical conditions in primary care was conducted in Puerto Rico [38]. Collaborative care included collaboration among physicians, mental health specialists and care managers as well as depression treatment [antidepressant medication with selective serotonin reuptake inhibitors (SSRI, mostly sertraline) or cognitive-behavioral therapy], patient education and follow-up visits [38].…”

Section: Evidence From Recent Randomized Controlled Clinical Trialsmentioning

confidence: 99%

“…Collaborative care included collaboration among physicians, mental health specialists and care managers as well as depression treatment [antidepressant medication with selective serotonin reuptake inhibitors (SSRI, mostly sertraline) or cognitive-behavioral therapy], patient education and follow-up visits [38]. The intervention had beneficial effects on depressive symptoms at the end of treatment (6 months; b: À0.03), depression improvement (OR: 4.04) and social functioning (b: 0.7) compared with usual care.…”

Section: Evidence From Recent Randomized Controlled Clinical Trialsmentioning

confidence: 99%

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Collaborative care for depression in medically ill patients

Baumeister

Hutter

2012

Current Opinion in Psychiatry

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Collaborative care interventions are efficacious in medically ill patients with depression. However, there is no data concerning their cost-effectiveness. Furthermore, as trials on collaborative care comprise a heterogeneous set of components, the most effective characteristics should be identified. Moreover, these interventions should be adapted to other healthcare systems than the United States.

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Collaborative Care for Depressed Patients With Chronic Medical Conditions: A Randomized Trial in Puerto Rico

Cited by 45 publications

References 35 publications

Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

Culturally Sensitive Intervention for Latina Women with Eating Disorders: A Case Study

The association between cognitive decline and incident depressive symptoms in a sample of older Puerto Rican adults with diabetes

Collaborative care for depression in medically ill patients

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