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- Behavioral Health (14)
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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 17 of 17 Research Studies DisplayedWright JH, Owen J, Eells TD
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. The purpose of this study was to evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.
AHRQ-funded; HS024047.
Citation: Wright JH, Owen J, Eells TD .
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
JAMA Netw Open 2022 Feb;5(2):e2146716. doi: 10.1001/jamanetworkopen.2021.46716..
Keywords: Depression, Behavioral Health, Primary Care, Treatments, Comparative Effectiveness
Kohler-Forsberg O, Sylvia LG, Fung V
Adjunctive antidepressant treatment among 763 outpatients with bipolar disorder: findings from the Bipolar CHOICE and LiTMUS trials.
The purpose of this study was to examine the clinical efficacy of adjunctive antidepressants. In this large cohort of outpatients with bipolar disorder, findings showed that clinically indicated and guideline-based adjunctive antidepressant treatment was not associated with lower depressive symptoms or higher mania symptoms.
AHRQ-funded; HS019371.
Citation: Kohler-Forsberg O, Sylvia LG, Fung V .
Adjunctive antidepressant treatment among 763 outpatients with bipolar disorder: findings from the Bipolar CHOICE and LiTMUS trials.
Depress Anxiety 2021 Feb;38(2):114-23. doi: 10.1002/da.23069..
Keywords: Depression, Behavioral Health, Medication, Comparative Effectiveness, Evidence-Based Practice, Outcomes
Katz D, Petersen T, Amado S
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
The impact of concurrent diagnosis posttraumatic stress disorder (PTSD) on persons with bipolar disorder (BD) was analyzed to determine if there was a higher risk of suicidal ideation. Baseline data from the 482 individuals enrolled in the Clinical and Health Outcomes Initiative in Comparative Effectiveness for bipolar disorder study (Bipolar CHOICE) was used. The association of comorbid PTSD with increased suicidal ideation was assessed by the Concise Health Risk Tracking Scale (CHRT) total and factor scores. As the authors hypothesized, diagnosis of comorbid PTSD was a significant predictor of the CHRT total score. All participants with comorbid PTSD (n=58) endorsed current suicidal ideation and were more likely to have had a previous suicide attempt compared to those without PTSD.
AHRQ-funded; HS019371.
Citation: Katz D, Petersen T, Amado S .
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
J Affect Disord 2020 Apr 1;266:49-56. doi: 10.1016/j.jad.2020.01.091..
Keywords: Behavioral Health, Risk, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Depression
Ochs-Ross R, Daly EJ, Zhang Y
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
This phase 3 double-blind study randomized patients with treatment-resistant depression age 65 or older to flexibly-dosed esketamine nasal spray and new oral antidepressant (esketamine/antidepressant) or new oral antidepressant and placebo nasal spray (antidepressant/placebo). The primary endpoint was change in the Montgomery-Asberg Depression Rating Scale (MADRS) over 28 days from baseline. Results showed that esketamine/antidepressant did not achieve statistical significance for patients ages 75 and older; however, greater differences were seen for patients ages 65-74 and patients with earlier onset of depression younger than age 55.
AHRQ-funded; HS023000.
Citation: Ochs-Ross R, Daly EJ, Zhang Y .
Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression-TRANSFORM-3.
Am J Geriatr Psychiatry 2020 Feb;28(2):121-41. doi: 10.1016/j.jagp.2019.10.008..
Keywords: Medication, Depression, Behavioral Health, Elderly, Comparative Effectiveness, Treatments, Evidence-Based Practice
Crits-Christoph P, Gallop R, Gaines A
Instrumental variable analyses for causal inference: application to multilevel analyses of the alliance-outcome relation.
In this paper, researchers introduced readers to instrumental variable analyses for causal inferences, using as an example a test of the hypothesis that the quality of the therapeutic alliance has a causal role in relation to the outcome of psychotherapy. They reported that their results supported their hypothesis that, at least at the therapist level, the alliance plays a causal role in producing better outcomes. They recommended that instrumental variable analyses be used as a tool to supplement standard analyses.
AHRQ-funded; HS022124; HS018440.
Citation: Crits-Christoph P, Gallop R, Gaines A .
Instrumental variable analyses for causal inference: application to multilevel analyses of the alliance-outcome relation.
Psychother Res 2020 Jan;30(1):53-67. doi: 10.1080/10503307.2018.1544724..
Keywords: Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness
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
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
Mathew SJ, Wilkinson ST, Altinay M
ELEctroconvulsive therapy (ECT) vs. Ketamine in patients with treatment-resistant depression: The ELEKT-D study protocol.
This article discusses the protocol that will be used for an ongoing study to compare electroconvulsive therapy (ECT) vs. ketamine for patients with treatment-resistant major depressive disorder (MDD). The study is being called ELEKT-D. Patients will be randomized between thrice-weekly ECT treatments or intravenous ketamine given twice weekly for 3-5 weeks. The objective of the study is to determine if ketamine will retain 90% of the ECT treatment effect. Additional outcomes to be measured include remission rates, depression severity, cognitive functioning, quality of live, adverse events, and tolerability.
AHRQ-funded; HS023000.
Citation: Mathew SJ, Wilkinson ST, Altinay M .
ELEctroconvulsive therapy (ECT) vs. Ketamine in patients with treatment-resistant depression: The ELEKT-D study protocol.
Contemp Clin Trials 2019 Feb;77:19-26. doi: 10.1016/j.cct.2018.12.009..
Keywords: Depression, Behavioral Health, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Wilkinson ST, Kiselycznyk C, Banasr M
Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression.
In this paper, the authors report serum brain-derived neurotrophic factor (BDNF) and plasma BDNF levels from a randomized controlled, adjunctive, sequential parallel comparison design trial of riluzole in major depressive disorder. The investigators noted that preliminary evidence suggested that lower baseline BDNF may be associated with better clinical response to riluzole.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Kiselycznyk C, Banasr M .
Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression.
J Affect Disord 2018 Dec 1;241:514-18. doi: 10.1016/j.jad.2018.08.075..
Keywords: Comparative Effectiveness, Depression, Medication, Patient-Centered Outcomes Research
Asher GN, Gartlehner G, Gaynes BN
Comparative benefits and harms of complementary and alternative medicine therapies for initial treatment of major depressive disorder: systematic review and meta-analysis.
The objective of this study was to report the comparative benefits and harms of exercise and complementary and alternative medicine (CAM) treatments with second-generation antidepressants (SGA) for major depressive disorder (MDD). The investigators indicated that although they found little difference in the comparative efficacy of most CAM therapies or exercise and SGAs, the overall poor quality of the available evidence base tempers any conclusions that they might draw from those trials.
AHRQ-funded; 290201200008I.
Citation: Asher GN, Gartlehner G, Gaynes BN .
Comparative benefits and harms of complementary and alternative medicine therapies for initial treatment of major depressive disorder: systematic review and meta-analysis.
Journal Altern Complement Med 2017 Dec;23(12):907-19. doi: 10.1089/acm.2016.0261..
Keywords: Comparative Effectiveness, Complementary and Alternative Medicine, Depression, Evidence-Based Practice, Behavioral Health
Zullo MD, Gathright EC, Dolansky MA
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
The purpose of this study was to examine the association between depression diagnosis and participation in cardiac rehabilitation (CR) in a large sample of Medicare beneficiaries with recent myocardial infarction (MI). It concluded that diagnosis of depression in Medicare beneficiaries was strongly associated with attending CR and attending more sessions of CR compared with those without depression. Depression is not a barrier to CR participation after MI in Medicare beneficiaries.
AHRQ-funded; HS019795.
Citation: Zullo MD, Gathright EC, Dolansky MA .
Influence of depression on utilization of cardiac rehabilitation postmyocardial infarction: A study of 158 991 Medicare beneficiaries.
J Cardiopulm Rehabil Prev 2017 Jan;37(1):22-29. doi: 10.1097/hcr.0000000000000222.
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Keywords: Heart Disease and Health, Depression, Medicare, Patient Adherence/Compliance, Comparative Effectiveness
Connolly Gibbons MB, Gallop R, Thompson D
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
The authors sought to determine whether dynamic psychotherapy (DT) is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Connolly Gibbons MB, Gallop R, Thompson D .
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
JAMA Psychiatry 2016 Sep;73(9):904-11. doi: 10.1001/jamapsychiatry.2016.1720.
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Keywords: Comparative Effectiveness, Community-Based Practice, Depression, Behavioral Health, Patient-Centered Outcomes Research
Gartlehner G, Gaynes BN, Amick HR
Comparative benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression: An evidence report for a clinical practice guideline from the American College of Physicians.
This evidence report compared the benefits and harms of second-generation antidepressants and psychological, complementary and alternative medicine (CAM), and exercise treatments as first- and second-step interventions for adults with acute major depressive disorder (MDD). It concluded tht, given their similar efficacy, cognitive behavioral therapy and antidepressants are both viable choices for initial treatment of MDD.
AHRQ-funded.
Citation: Gartlehner G, Gaynes BN, Amick HR .
Comparative benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression: An evidence report for a clinical practice guideline from the American College of Physicians.
Ann Intern Med 2016 Mar 1;164(5):331-41. doi: 10.7326/m15-1813.
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Keywords: Medication, Comparative Effectiveness, Complementary and Alternative Medicine, Depression, Behavioral Health
Amick HR, Gartlehner G, Gaynes BN
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
This systematic review sought to identify the benefits and harms of second generation antidepressants and cognitive behavioral therapies (CBTs) in the initial treatment of a current episode of major depressive disorder in adults. It concluded that the available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences.
AHRQ-funded; 290-2012-00008I
Citation: Amick HR, Gartlehner G, Gaynes BN .
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
BMJ 2015 Dec 8;351:h6019. doi: 10.1136/bmj.h6019..
Keywords: Medication, Behavioral Health, Comparative Effectiveness, Depression
Chung H, Kim J, Askew RL
Assessing measurement invariance of three depression scales between neurologic samples and community samples.
The purpose of this study was to test measurement invariance of three patient-reported measures of depressive symptoms between neurologic and community samples. Its results suggest that depressive symptoms as measured by three different outcome measures have the same meaning across clinical and community samples. Thus, the use of these measures for group comparisons is supported.
AHRQ-funded; HS020700.
Citation: Chung H, Kim J, Askew RL .
Assessing measurement invariance of three depression scales between neurologic samples and community samples.
Qual Life Res 2015 Aug;24(8):1829-34. doi: 10.1007/s11136-015-0927-5..
Keywords: Depression, Outcomes, Comparative Effectiveness
Gibbons MB, Thompson SM, Mack RA
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
The researchers explored the role of baseline skills deficits in compensatory skills and self-understanding across both cognitive and dynamic treatment modalities. Their results support a capitalization model for cognitive therapy but failed to support either a compensation model or a capitalization model for the short-term dynamic model.
AHRQ-funded; HS022124.
Citation: Gibbons MB, Thompson SM, Mack RA .
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
J Clin Psychol 2015 Jun;71(6):491-9. doi: 10.1002/jclp.22165..
Keywords: Comparative Effectiveness, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Bobo WV, Reilly-Harrington NA, Ketter TA
Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: results from the Bipolar CHOICE trial.
This study investigated the longer-term effects of adjunctive benzodiazepines on symptom response during treatment in patients with bipolar disorders. The investigators concluded that adjunctive benzodiazepines may not significantly affect clinical outcome in lithium- or quetiapine-treated patients with bipolar I or II disorder over 6 months, after controlling for potential confounding factors.
AHRQ-funded; HS019371.
Citation: Bobo WV, Reilly-Harrington NA, Ketter TA .
Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: results from the Bipolar CHOICE trial.
J Affect Disord 2014 Jun;161:30-5. doi: 10.1016/j.jad.2014.02.046..
Keywords: Comparative Effectiveness, Depression, Medication, Behavioral Health, Treatments