The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking.

Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression.

How a therapy-based quality improvement intervention for depression affected life events and psychological well-being over time: a 9-year longitudinal analysis.

Background: Short-term quality improvement (QI) interventions for depression can improve long-term mental health but mechanisms are unknown. We hypothesized that 1 pathway for such health benefits was an indirect effect with QI reducing risk factors for depression such as stressful life events.

Objective: To determine whether 6-12 month QI programs for depression reduce negative life events at 5-year follow-up and to model the relationship between program implementation, life events and mental health over 9 years.

Do the effects of quality improvement for depression care differ for men and women? Results of a group-level randomized controlled trial.

Objective: We sought to examine whether a quality improvement (QI) program for depression care is effective for both men and women and whether their responses differed.

Design: We instituted a group-level, randomized, controlled trial in 46 primary care practices within 6 managed care organizations. Clinics were randomized to usual care or to 1 of 2 QI programs that supported QI teams, provider training, nurse assessment and patient education, and resources to support medication management (QI-Meds) or psychotherapy (QI-Therapy).

Alcohol, drug abuse, and mental health care for uninsured and insured adults.

Objective: To compare adults with different insurance coverage in care for alcohol, drug abuse, and mental health (ADM) problems.

Data Sources/study Setting: From a national telephone survey of 9,585 respondents.

Design: Follow-up of adult participants in the Community Tracking Study.

Treating panic disorder in primary care: a collaborative care intervention.

Efficacy research indicates the success of cognitive behavioral treatment and medication treatment for panic disorder with or without agoraphobia. However, research findings to date possess limited generalizability beyond specialty mental health settings. We present a model for collaborative care treatment for panic disorder in the primary care setting that combines cognitive behavioral therapy and medications, and involves a behavioral health specialist, psychiatrist, and primary care physician.