National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 70 Research Studies DisplayedLiu FF, Adrian MC
Is treatment working? Detecting real change in the treatment of child and adolescent depression.
Effectiveness of evidence-based treatments for youth remain modest at best; while practice parameters recommend measurement-based care to enhance youth depression treatment, the literature offers few guidelines on how to use assessment results to inform care decisions or to detect real and clinically meaningful change. The purpose of this study was to produce reliable change indices for two commonly used standardized assessments of youth depression: Patient Health Questionnaire-9 items, Modified for Adolescents (PHQ-9A) and the Short Moods and Feelings Questionnaire (SMFQ).
AHRQ-funded; HS022982.
Citation: Liu FF, Adrian MC .
Is treatment working? Detecting real change in the treatment of child and adolescent depression.
J Am Acad Child Adolesc Psychiatry 2019 Dec;58(12):1157-64. doi: 10.1016/j.jaac.2019.02.011..
Keywords: Children/Adolescents, Depression, Behavioral Health, Evidence-Based Practice, Patient-Centered Outcomes Research
Mills J, Day B
AHRQ Author: Mills J
Interventions to prevent perinatal depression.
This case study relates to interventions to prevent perinatal depression. It includes a case description as well as follow up questions and answers.
AHRQ-authored.
Citation: Mills J, Day B .
Interventions to prevent perinatal depression.
Am Fam Physician 2019 Sep 15;100(6):365-66..
Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Depression, Behavioral Health, Prevention, Women, Case Study
Sakurai H, Dording C, Yeung A
Longer-term open-label study of adjunctive riluzole in treatment-resistant depression.
While riluzole has been investigated for the treatment of depression, little is known about its longer-term efficacy and optimal treatment duration in treatment-resistant depression (TRD). The objective of this study was to characterize the longer-term outcome of adjunctive riluzole therapy for TRD in an open-label extension of an 8-week acute treatment trial. The investigators concluded that longer-term adjunctive riluzole appeared relatively well tolerated and beneficial for maintaining previous response.
AHRQ-funded; HS023000.
Citation: Sakurai H, Dording C, Yeung A .
Longer-term open-label study of adjunctive riluzole in treatment-resistant depression.
J Affect Disord 2019 Nov 1;258:102-08. doi: 10.1016/j.jad.2019.06.065..
Keywords: Depression, Behavioral Health, Medication, Patient-Centered Outcomes Research, Outcomes
Bardach NS, Neel C, Kleinman LC
Depression, anxiety, and emergency department use for asthma.
This study examined whether pediatric patients with asthma who use the emergency department (ED) experience increased depression and anxiety in the same way that adult asthma patients do. Out of 65,342 patients identified from the Massachusetts All-Payer Claims Database for 2014 to 2015 who had ED visits, 24.7% had a diagnosis of anxiety, depression, or both. Asthma rates were shown to be higher than those of patients who had no diagnosis of anxiety or depression.
AHRQ-funded; HS025297; HS020518.
Citation: Bardach NS, Neel C, Kleinman LC .
Depression, anxiety, and emergency department use for asthma.
Pediatrics 2019 Oct;144(4). doi: 10.1542/peds.2019-0856..
Keywords: Asthma, Depression, Anxiety, Children/Adolescents, Emergency Department, Behavioral Health
Addington EL, Cheung EO, Bassett SM
The MARIGOLD study: feasibility and enhancement of an online intervention to improve emotion regulation in people with elevated depressive symptoms.
This paper described the first two phases of pilot testing of MARIGOLD; MARIGOLD is an online self-guided positive emotion skills intervention for adults with elevated depressive symptoms, along with enhancements to overcome retention and adherence problems reported in previous research. Results suggested that positive emotion skills, plus enhancements for web-based, self-guided delivery, warrant additional study in people with elevated depressive symptoms.
AHRQ-funded; HS000084.
Citation: Addington EL, Cheung EO, Bassett SM .
The MARIGOLD study: feasibility and enhancement of an online intervention to improve emotion regulation in people with elevated depressive symptoms.
J Affect Disord 2019 Oct 1;257:352-64. doi: 10.1016/j.jad.2019.07.049..
Keywords: Depression, Behavioral Health, Telehealth, Health Information Technology (HIT), Education: Patient and Caregiver
Birk JL, Kronish IM, Moise N
Depression and multimorbidity: considering temporal characteristics of the associations between depression and multiple chronic diseases.
This two-part study examined temporal patterns of depression with 4 common diseases: hypertension, ischemic heart disease, arthritis, and diabetes. The first study assessed how prior chronic disease diagnosis was associated with current depression. The second study evaluated the extent that depression is associated with the diagnosis of these 4 prevalent chronic diseases. Study 1 showed depression had the fourth highest betweenness centrality ranking of 26 network nodes. Study 2 determined that depression is associated with incidence of ischemic heart disease and diabetes, but there was insufficient information on associations with hypertension and arthritis.
AHRQ-funded; HS025198.
Citation: Birk JL, Kronish IM, Moise N .
Depression and multimorbidity: considering temporal characteristics of the associations between depression and multiple chronic diseases.
Health Psychol 2019 Sep;38(9):802-11. doi: 10.1037/hea0000737..
Keywords: Depression, Behavioral Health, Chronic Conditions
Wilkinson ST, Howard DH, Busch SH
Psychiatric practice patterns and barriers to the adoption of esketamine.
This paper discusses the psychiatric practice patterns and barriers to the adoption of esketamine in the treatment of depression. The authors indicate that the discovery of ketamine’s rapid-acting properties, culminating most recently with the FDA’s approval of esketamine, offers hope to the large numbers of patients whose symptoms do not resolve with traditional treatments. However, they suggest, many traditional psychiatric practices may be reluctant to invest in the costly infrastructure necessary to provide this therapy, especially because of the uncertainty regarding the reimbursement for patient monitoring.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Howard DH, Busch SH .
Psychiatric practice patterns and barriers to the adoption of esketamine.
JAMA 2019 Sep 17;322(11):1039-40. doi: 10.1001/jama.2019.10728.
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Keywords: Depression, Behavioral Health, Practice Patterns, Medication
Burnett-Zeigler I, Satyshur MD, Hong S
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
The authors examined the acceptability and feasibility of a mindfulness-based group intervention for socio-economically disadvantaged women in an urban community health center. Participants reported benefits to the intervention as well as barriers to session attendance. The authors concluded that the mindfulness-based intervention for depression was acceptable, reduced stress, and improved coping and functioning among women in a community health center.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Satyshur MD, Hong S .
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
Complement Ther Med 2019 Aug;45:19-24. doi: 10.1016/j.ctim.2019.05.012..
Keywords: Community-Based Practice, Depression, Behavioral Health, Racial and Ethnic Minorities, Women
Sobieraj DM, Martinez BK, Hernandez AV
Adverse effects of pharmacologic treatments of major depression in older adults.
The objective of this study was to assess adverse effects of pharmacologic antidepressants for treatment of major depressive disorder (MDD) in adults 65 years of age or older. The investigators found, among other conclusions, that in patients 65 years of age or older with MDD, treatment of the acute phase of MDD with serotonin norepinephrine reuptake inhibitors (SNRIs), but not selective serotonin reuptake inhibitors (SSRIs), was associated with a statistically greater number of overall adverse events vs placebo.
AHRQ-funded; 290201500012I.
Citation: Sobieraj DM, Martinez BK, Hernandez AV .
Adverse effects of pharmacologic treatments of major depression in older adults.
J Am Geriatr Soc 2019 Aug;67(8):1571-81. doi: 10.1111/jgs.15966..
Keywords: Depression, Behavioral Health, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Elderly
Brunsberg KA, Landrigan CP, Garcia BM
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
The objective of this paper was to determine whether higher rates of medical errors were associated with positive screenings for depression or burnout among resident physicians. Results of this prospective cohort study showed that resident physicians with a positive depression screen were three times more likely than those who screened negative to make harmful errors, indicating the importance of determining what interventions might mitigate the patient safety risk.
AHRQ-funded; HS019456.
Citation: Brunsberg KA, Landrigan CP, Garcia BM .
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
Acad Med 2019 Aug;94(8):1150-56. doi: 10.1097/acm.0000000000002778..
Keywords: Children/Adolescents, Provider: Physician, Provider, Medical Errors, Adverse Events, Burnout, Patient Safety, Depression, Behavioral Health
Beiser DG, Ward CE, Vu M
Depression in emergency department patients and association with health care utilization.
Depression is one of the most common illnesses in the United States, with increased prevalence among people with lower socioeconomic status and chronic mental illness who often seek care in the emergency department (ED). The investigators sought to estimate the rate and severity of major depressive disorder (MDD) in a nonpsychiatric ED population and its association with subsequent ED visits and hospitalizations.
AHRQ-funded; HS000084; HS025889.
Citation: Beiser DG, Ward CE, Vu M .
Depression in emergency department patients and association with health care utilization.
Acad Emerg Med 2019 Aug;26(8):878-88. doi: 10.1111/acem.13726..
Keywords: Depression, Emergency Department, Healthcare Utilization, Hospitalization, Behavioral Health
Adrian M, Jenness JL, Kuehn KS
Emotion regulation processes linking peer victimization to anxiety and depression symptoms in adolescence.
This study examined emotional regulation processes linked to anxiety and depression symptoms in adolescents experiencing peer victimization. A total of 287 adolescents aged 16-17 years were recruited in three urban centers in the United States. They completed baseline and follow-up assessments 4 months apart. Three models of emotion regulation were evaluated using confirmatory factor analysis. Difficulties with emotion regulation were associated with increased depression in adolescents experiencing peer victimization and increased anxiety associated with cognitive regulation difficulties.
AHRQ-funded; HS022982.
Citation: Adrian M, Jenness JL, Kuehn KS .
Emotion regulation processes linking peer victimization to anxiety and depression symptoms in adolescence.
Dev Psychopathol 2019 Aug;31(3):999-1009. doi: 10.1017/s0954579419000543..
Keywords: Anxiety, Depression, Children/Adolescents, Behavioral Health
Gibbons MBC, Gallop R, Thompson D
Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting.
The goal of this study was to evaluate treatment attendance patterns, including both treatment completion and premature termination from treatment, for two evidence-based psychotherapies for major depressive disorder delivered in a community mental health setting. Results showed that very early termination from services was higher in cognitive therapy compared with dynamic therapy, suggesting that including techniques to improve engagement in both therapies and matching patients to treatment based on predictors/moderators may be effective ways to optimize treatment engagement.
AHRQ-funded; HS018440; HS022124.
Citation: Gibbons MBC, Gallop R, Thompson D .
Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting.
J Consult Clin Psychol 2019 Aug;87(8):745-55. doi: 10.1037/ccp0000414..
Keywords: Depression, Behavioral Health, Patient and Family Engagement
Hill LM, Golin CE, Gottfredson NC
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
The purpose of this study was to identify the mechanisms involved with antiretroviral therapy (ART) non-adherence among people living with HIV (PLHIV) after release from prison. Results showed that, on average, study participants achieved 79% ART adherence. Greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Results suggested that depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
AHRQ-funded; HS000032.
Citation: Hill LM, Golin CE, Gottfredson NC .
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
AIDS Behav 2019 Aug;23(8):2037-47. doi: 10.1007/s10461-018-2355-3..
Keywords: Behavioral Health, Depression, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Substance Abuse, Vulnerable Populations
Lipira L, Williams EC, Huh D
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
Investigators recruited a sample of African-American women living with HIV to participate in a stigma-reduction intervention. The women lived in Chicago and Birmingham from 2013 to 2015. The relationship between HIV-related stigma and viral suppression was evaluated and the role of depression and nonadherence to antiretroviral therapy (ART) was assessed. Among 100 women who participated 95% reported some level of HIV-related stigma. Those who reported higher levels of stigma did have lower odds of being virally suppressed. The indirect effects of depression and ART nonadherence were not statistically significant.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Huh D .
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
AIDS Behav 2019 Aug;23(8):2025-36. doi: 10.1007/s10461-018-2301-4..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Stigma, Women
Yeh VM, Mayberry LS, Bachmann JM
Depressed mood, perceived health competence and health behaviors: a cross-sectional mediation study in outpatients with coronary heart disease.
Identifying potential mechanisms that link depressed mood with worse health behaviors is important given the prevalence of depressed mood in patients with coronary heart disease (CHD) and its relationship with subsequent mortality. Perceived health competence is an individual's confidence in his/her ability to successfully engineer solutions to achieve health goals and may explain how depressed mood affects multiple health behaviors. The objective of this study was to examine whether or not perceived health competence mediated the relationship between depressed mood and worse health behaviors.
AHRQ-funded; HS022990.
Citation: Yeh VM, Mayberry LS, Bachmann JM .
Depressed mood, perceived health competence and health behaviors: a cross-sectional mediation study in outpatients with coronary heart disease.
J Gen Intern Med 2019 Jul;34(7):1123-30. doi: 10.1007/s11606-018-4767-1..
Keywords: Depression, Behavioral Health, Heart Disease and Health, Cardiovascular Conditions, Patient Adherence/Compliance
Burnett-Zeigler I, Hong S, Waldron EM
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
The authors piloted a streamlined mindfulness teacher training protocol for Federally Qualified Health Center (FQHC) staff. They also examined the distribution and variability of psychologic outcomes for participants in groups led by an experienced instructor compared to a FQHC staff instructor who received the streamlined training. They concluded that preliminary data indicate that health care staff who receive streamlined training to deliver mindfulness-based interventions have comparable outcomes as experienced instructors.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Hong S, Waldron EM .
A mindfulness-based intervention for low-income African American women with depressive symptoms delivered by an experienced instructor versus a novice instructor.
J Altern Complement Med 2019 Jul;25(7):699-708. doi: 10.1089/acm.2018.0393..
Keywords: Behavioral Health, Comparative Effectiveness, Depression, Low-Income, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Vulnerable Populations, Training, Women
Lipira L, Williams EC, Nevin PE
Religiosity, social support, and ethnic identity: exploring "resilience resources" for African-American women experiencing HIV-related stigma.
The objective of this study was to evaluate whether religiosity, social support, and ethnic identity moderate the effects of HIV-related stigma on depression among African-American women living with HIV. Results showed that the protective effects of religiosity may be leveraged in interventions for African-American women living with HIV struggling with HIV-related stigma.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Nevin PE .
Religiosity, social support, and ethnic identity: exploring "resilience resources" for African-American women experiencing HIV-related stigma.
J Acquir Immune Defic Syndr 2019 Jun;81(2):175-83. doi: 10.1097/qai.0000000000002006..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Social Stigma, Women, Depression, Behavioral Health
Wilkinson ST, Farmer C, Ballard E
Impact of midazolam vs. saline on effect size estimates in controlled trials of ketamine as a rapid-acting antidepressant.
The article describes a study on the effectiveness of midazolam as a comparator in preserving the blind in ketamine studies for mood disorders. Four groups -- ketamine (midazolam-controlled), ketamine (saline-controlled), midazolam, and saline -- were compared with regard to clinical outcomes. The effect of ketamine was larger in saline-controlled studies than in midazolam-controlled studies, relative to control, but there was no difference between ketamine (midazolam-controlled) and ketamine (saline-controlled). The response rate for ketamine was higher than the control condition for both saline and midazolam.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Farmer C, Ballard E .
Impact of midazolam vs. saline on effect size estimates in controlled trials of ketamine as a rapid-acting antidepressant.
Neuropsychopharmacology 2019 Jun;44(7):1233-38. doi: 10.1038/s41386-019-0317-8.
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Keywords: Medication, Comparative Effectiveness, Depression, Behavioral Health, Patient-Centered Outcomes Research
Sorkin DH, Rizzo S, Biegler K
AHRQ Author: Ngo-Metzger Q
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
This article describes a multicomponent health information technology screening tool designed to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder (PTSD) in the primary care setting, with an eye toward meeting the mental health needs of traumatized refugees in the US Cambodian community. In a randomized controlled trial, 18 primary care providers were randomized to receive access to the mental health screening intervention, or to a minimal intervention control group. Cambodian American patients empaneled to participating providers were assigned to the providers' randomized group. From the results, the authors conclude that this approach offers the potential for training providers to diagnose and treat traumatized patients seeking mental health care in primary care.
AHRQ-authored.
Citation: Sorkin DH, Rizzo S, Biegler K .
Novel health information technology to aid provider recognition and treatment of major depressive disorder and posttraumatic stress disorder in primary care.
Med Care 2019 Jun;57 Suppl 6 Suppl 2:S190-s96. doi: 10.1097/mlr.0000000000001036..
Keywords: Depression, Diagnostic Safety and Quality, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Racial and Ethnic Minorities, Screening
Levis B, Benedetti A, Thombs BD
Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis.
This study’s goal was to determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) in diagnosing major depression. A bivariate random effects meta-analysis was done to estimate sensitivity and specificity for cut-off scores 5-15. It was determined that the PHQ-9 is similarly sensitive for use as the Mini International Neuropychiatric (MINI) diagnosis tool, but may be less specific for younger patients. However, a cut-off score of 10 or above can be used regardless of age.
AHRQ-funded; HS018246.
Citation: Levis B, Benedetti A, Thombs BD .
Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis.
BMJ 2019 Apr 9;365:l1476. doi: 10.1136/bmj.l1476..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health, Screening
Rinke ML, German M, Azera B
Effect of mental health screening and integrated mental health on adolescent depression-coded visits.
This article describes a retrospective primary care network natural cohort study to analyze how mental health screening and integrated mental health practitioners affect adolescent depression identification. The percentage of depression-coded adolescent visits were compared between practices with and without mental health screening and with and without integrated mental health practitioners, using difference-in-differences analyses. The authors conclude that adolescent mental health screening and integrated mental health practitioners increase depression-coded visits in primary care.
AHRQ-funded; HS0203608.
Citation: Rinke ML, German M, Azera B .
Effect of mental health screening and integrated mental health on adolescent depression-coded visits.
Clin Pediatr 2019 Apr;58(4):437-45. doi: 10.1177/0009922818821889..
Keywords: Children/Adolescents, Depression, Diagnostic Safety and Quality, Primary Care, Screening
Kemmick Pintor J, Mitchell DC, Schenker MB
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
This study explored if depression affects treatment for obesity among Latino immigrant farmworkers. The workplace pilot study called Pasos Saludables,was successful, but the participants at risk for depression had lower weight loss than the participants with no indication of depression.
AHRQ-funded; HS022236.
Citation: Kemmick Pintor J, Mitchell DC, Schenker MB .
Exploring the role of depression as a moderator of a workplace obesity intervention for latino immigrant farmworkers.
J Immigr Minor Health 2019 Apr;21(2):383-92. doi: 10.1007/s10903-018-0743-4..
Keywords: Depression, Behavioral Health, Obesity, Racial and Ethnic Minorities, Vulnerable Populations
Wilkinson ST, Holtzheimer PE, Gao S
Leveraging neuroplasticity to enhance adaptive learning: the potential for synergistic somatic-behavioral treatment combinations to improve clinical outcomes in depression.
This article reviews the potential of synergistically combining plasticity-enhancing and behavioral therapies to develop translational treatment approaches for depression. After reviewing relevant neuroplasticity deficits in depression, the article surveys biological treatments that appear to reverse such deficits in humans; evidence that directly or indirectly supports the hypothesis that a robust enhancement of neuroplasticity through these methods might promote the uptake of cognitive and behavioral interventions to enhance longer-term treatment outcomes is then reviewed. The authors identify missing pieces of key evidence and discuss future directions that could enhance this line of research.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Holtzheimer PE, Gao S .
Leveraging neuroplasticity to enhance adaptive learning: the potential for synergistic somatic-behavioral treatment combinations to improve clinical outcomes in depression.
Biol Psychiatry 2019 Mar 15;85(6):454-65. doi: 10.1016/j.biopsych.2018.09.004..
Keywords: Behavioral Health, Depression, Patient-Centered Outcomes Research, Treatments
Turan B, Crockett KB, Buyukcan-Tetik A
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
One mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. In this study, the investigators examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. They also investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.
AHRQ-funded; HS013852.
Citation: Turan B, Crockett KB, Buyukcan-Tetik A .
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
J Acquir Immune Defic Syndr 2019 Mar;80(3):284-91. doi: 10.1097/qai.0000000000001915..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Social Stigma