TY  - JOUR
A1  - Petersen, Juliana
A1  - Hartig, Johannes
A1  - Paulitsch, Michael Anton
A1  - Pagitz, Manuel
A1  - Mergenthal, Karola
A1  - Rauck, Sandra
A1  - Reif, Andreas
A1  - Gerlach, Ferdinand M.
A1  - Gensichen, Jochen
T1  - Classes of depression symptom trajectories in patients with major depression receiving a collaborative care intervention
T2  - PLoS one
N2  - Purpose: Collaborative care is effective in improving symptoms of patients with depression. The aims of this study were to characterize symptom trajectories in patients with major depression during one year of collaborative care and to explore associations between baseline characteristics and symptom trajectories.
Methods: We conducted a cluster-randomized controlled trial in primary care. The collaborative care intervention comprised case management and behavioral activation. We used the Patient Health Questionnaire-9 (PHQ-9) to assess symptom severity as the primary outcome. Statistical analyses comprised latent growth mixture modeling and a hierarchical binary logistic regression model.
Results: We included 74 practices and 626 patients (310 intervention and 316 control recipients) at baseline. Based on a minimum of 12 measurement points for each intervention recipient, we identified two latent trajectories, which we labeled "fast improvers" (60.5%) and "slow improvers" (39.5%). At all measurements after baseline, "fast improvers" presented higher PHQ mean values than "slow improvers". At baseline, "fast improvers" presented fewer physical conditions, higher health-related quality of life, and had made fewer suicide attempts in their history.
Conclusions: A notable proportion of 39.5% of patients improved only "slowly" and probably needed more intense treatment. The third follow-up in month two could well be a sensible time to adjust treatment to support "slow improvers".
KW  - Depression
KW  - Primary care
KW  - Diagnostic medicine
KW  - Quality of life
KW  - Patients
KW  - Physicians
KW  - Suicide
KW  - Mental health and psychiatry
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/47176
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-471763
SN  - 1932-6203
N1  - Copyright: © 2018 Petersen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 13
IS  - (9): e0202245
SP  - 1
EP  - 13
PB  - PLoS
CY  - Lawrence, Kan.
ER  -