Collaborative Care for Obstetric Patients With Depression Improves Symptoms, Satisfaction With Care, Study Shows

Collaborative depression care adapted to women's health settings appears to improve depressive and functional outcomes and quality of depression care, according to a report online in the journal Obstetrics and Gynecology. Researchers at the University of Washington randomized 102 women to 12 months of collaborative depression management and 103 women to usual obstetric care at two obstetric care sites. All of the women met criteria for major depression, dysthymia, or both. Participants were age 39 on average, and 56 percent had a diagnosis of posttraumatic stress disorder.

The collaborative care model is team-based care that involves psychiatrists, other clinicians, and depression care managers who meet weekly to review patient progress and provide treatment recommendations. The care manager follows up with patients.

Outcomes at six- month, 12-month, and 18-month follow-ups were compared. The primary outcomes were change from baseline to 12 months in depression symptoms and functional status. Secondary outcomes included at least 50 percent decrease and remission in depressive symptoms, global improvement, treatment satisfaction, and quality of care.

Patients receiving collaborative care had greater improvement in depressive symptoms at 12 months and 18 months and improved functioning over the course of 18 months. They were also more likely to have at least 50 percent decrease in depressive symptoms at 12 months, greater likelihood of at least four specialty mental health visits, to be taking an adequate dose of an antidepressant, and to express greater satisfaction with care.

To read more about collaborative care for patients with psychiatric illness, see the Psychiatric News article, "Collaborative Care for Depression Can Reduce Risk for Hearts Attacks, Stroke."

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