Minor depression is one of the most common types of depressive disorders in primary care. It is not clear that antidepressants are indicated for minor depression, and even if they are, a substantial proportion of patients cannot or will not take them. Alternative treatment approaches are indicated. The purpose of this project is to use a four-week watchful waiting period to identify patients with persistent minor depression, potentially most in need of depression specific treatment, and then test the therapeutic effect of Problem- Solving Treatment for Primary Care (PST-PC), a manual driven, six-session, behavioral treatment for depression in primary care. In this project, 300 primary care, minor depression patients will be identified and followed. The relationship of patient predictors to remission will be examined. After four weeks, patients who do not demonstrate symptomatic remission (approximately 50 percent or 150 patients) will be entered into a randomized nine-week clinical trial comparing PST-PC with Usual Care. Subjects will be followed for six months after completing the trial. The primary aim of this project is to test the therapeutic effect of PST-PC versus Usual Care for persistent minor depression in primary care. As a subsidiary aim the project will examine the relationship of characteristics of the patient (social support, adverse life events, personality traits, comorbidity) to early remission of minor depression. Patient and therapy characteristics will also be examined as predictors of recovery six months after the trial. The broader, long-term goal of this line of investigation is to disseminate practical, non-pharmacologic mental health treatments for use by non-physician practitioners (e.g. psychologists, nurses, social workers, counselors) who will increasingly be working in primary care.
| Oxman, Thomas E; Hegel, Mark T; Hull, Jay G et al. (2008) Problem-solving treatment and coping styles in primary care for minor depression. J Consult Clin Psychol 76:933-43 |
| Hegel, Mark T; Oxman, Thomas E; Hull, Jay G et al. (2006) Watchful waiting for minor depression in primary care: remission rates and predictors of improvement. Gen Hosp Psychiatry 28:205-12 |
| Oxman, Thomas E; Sengupta, Anjana (2002) Treatment of minor depression. Am J Geriatr Psychiatry 10:256-64 |
