Organized Self-Management Support Services for Chronic Depressive Symptoms: A Randomized Controlled Trial.

Objective: This study aimed to determine whether a self-management support service was more effective than treatment as usual in reducing depressive symptoms and major depressive episodes and increasing personal recovery among individuals with chronic or recurrent depressive symptoms.

Methods: The study was a randomized controlled trial of a self-management support service consisting of depression self-management training, recovery coaching, and care coordination. The 18-month intervention included regular telephone or in-person contacts with a care manager and a structured group program co-led by a professional therapist and a trained peer specialist.

Factors associated with successful discontinuation of hormone therapy.

Background: Careful management of symptoms, particularly sleep and mood disturbances, may assist women in discontinuing hormone therapy (HT). We sought to describe characteristics associated with successful HT cessation in women who attempted to discontinue estrogen pills/patches with or without progestin.

Methods: We invited 2,328 women, aged 45-70, enrolled January 1, 2005, to May 31, 2006, at Group Health in Washington State and Harvard Vanguard Medical Associates in Massachusetts, to participate in a telephone survey about HT practices.

Telephone cognitive-behavioral therapy for subthreshold depression and presenteeism in workplace: a randomized controlled trial.

Background: Subthreshold depression is highly prevalent in the general population and causes great loss to society especially in the form of reduced productivity while at work (presenteeism). We developed a highly-structured manualized eight-session cognitive-behavioral program with a focus on subthreshold depression in the workplace and to be administered via telephone by trained psychotherapists (tCBT).

Methods: We conducted a parallel-group, non-blinded randomized controlled trial of tCBT in addition to the pre-existing Employee Assistance Program (EAP) versus EAP alone among workers with subthreshold depression at a large manufacturing company in Japan.

Hormone therapy discontinuation: physician practices after the Women's Health Initiative.

Objective: No guidelines or randomized trials address best practices for hormone therapy (HT) discontinuation.

Methods: We conducted a survey study to explore HT discontinuation practices at Group Health and Harvard Vanguard, large integrated health systems in the Northwest and Northeast United States, focusing on differences between specialties and study site.

Results: The response rate to the written questionnaire (mailed between December 2005 and May 2006) was 78.

Provider attributes associated with hormone therapy prescribing frequency.

Objective: The aim of this study was to identify provider characteristics associated with hormone therapy prescribing.

Methods: The study design is cross-sectional. In December 2005, we mailed surveys to providers practicing in two integrated healthcare delivery systems located in the northwestern and northeastern United States; 379 responded (74%) and 249 (49% of total) granted access to their automated data.

Depressive symptoms and menopausal burden in the midlife.

Objective: The goal of this study was to assess whether menopausal symptoms were more common and/or more severe among women with depressive symptoms.

Methods: A cross-sectional survey of 1358 women, ages 45-70, at two large integrated health plans (Seattle; Boston) was performed. Information on demographics, medical and reproductive history, medication use, menopausal experience and depressive symptoms (PHQ-8) were collected.

Vaginal, endometrial, and reproductive hormone findings: randomized, placebo-controlled trial of black cohosh, multibotanical herbs, and dietary soy for vasomotor symptoms: the Herbal Alternatives for Menopause (HALT) Study.

Objective: To evaluate vaginal, endometrial, and reproductive hormone effects of three herbal regimens compared with placebo and hormone therapy (HT).

Design: This was a 1-year, randomized, double-blind, placebo-controlled trial of 351 women, ages 45 to 55, with two or more vasomotor symptoms per day. Women were randomly assigned to (1) black cohosh, (2) a multibotanical containing black cohosh, (3) the same multibotanical plus dietary soy counseling, (4) HT, or (5) placebo.

A pilot study of telephone care management and structured disease self-management groups for chronic depression.

Objective: The authors developed, implemented, and pilot-tested intervention programs to provide effective care for chronic or recurrent depression.

Methods: A total of 104 patients with chronic or recurrent depression were randomly assigned to one of four groups: continued usual behavioral health care, usual care plus telephone monitoring and care management by a care manager, usual care plus care management plus a peer-led chronic-disease self-management group program, or usual care plus care management plus a professionally led depression psychotherapy group. Outcomes in intent-to-treat analyses were assessed at three, six, nine, and 12 months and included treatment participation rates, Hopkins Symptom Checklist depression scale scores, major depression (Structured Clinical Interview for DSM-IV), Patient-Rated Global Improvement ratings, treatment satisfaction, and adequacy of medication.

The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin.

Objective: Black cohosh (Actaea racemosa) is an herb commonly used to treat menopausal symptoms. Little is known about its effect on other physiologic parameters that could result in untoward events. This study examines the effect of black cohosh on lipids, fibrinogen, glucose and insulin.

Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial.

Background: Herbal supplements are widely used for vasomotor symptoms.

Objective: To test the efficacy of 3 herbal regimens and hormone therapy for relief of vasomotor symptoms compared with placebo.

Design: 1-year randomized, double-blind, placebo-controlled trial conducted from May 2001 to September 2004.

Depressed mood and smoking experimentation among preteens.

The authors examined children's depressed mood, parental depressed mood, and parental smoking in relation to children's smoking susceptibility and experimentation over 20 months in a cohort of 418 preteens (ages 10-12 at baseline) and their parents. Depressed mood in preteens was strongly related to experimentation but not to susceptibility. In cross-sectional analyses parental depressed mood was related to children's experimentation, but in longitudinal analyses parental depressed mood at baseline did not differentiate children who experimented from those who did not.

A randomized trial of a brief primary-care-based intervention for reducing at-risk drinking practices.

This randomized trial evaluated an intervention for reducing at-risk drinking practices in a sample of 307 patients. Eligible drinking patterns included chronic drinking (> or = 2 drinks per day in the past month), binge drinking (> or = 5 drinks per occasion at least twice in the past month), and drinking and driving (driving after > 2 drinks in the past month). Members of the intervention group received a message from their physician during their regularly scheduled visit, a self-help manual, written personalized feedback, and up to 3 telephone counseling calls.

Women's reports of smoking cessation advice during reproductive health visits and subsequent smoking cessation.

Objective: To examine associations of women's characteristics with reports of provider advice to quit smoking and smoking cessation 1 year after a reproductive health visit.

Study Design: Prospective survey.

Methods: As part of a randomized smoking cessation trial, 432 women smokers completed telephone surveys 1 month and 1 year after their reproductive health visit.

Depressive symptoms, stress, and weight concerns among African American and European American low-income female smokers.

The relationships between perceived stress, depressive symptoms, concern about weight gain and smoking dependence were examined among 83 European American and 175 African American female smokers bringing children to pediatric clinics serving a low-income population. Among African American women, but not European American women, greater stress and more depressive symptoms predicted greater smoking dependence, and less concern about weight gain predicted greater smoking dependence. Multivariate analyses confirmed the bivariate relationships among stress, depressive symptoms, and smoking dependence among African American women but reduced the relationship between weight concern and smoking dependence.