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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Anxiety (3)
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- Chronic Conditions (2)
- (-) Depression (19)
- (-) Diagnostic Safety and Quality (19)
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- Neurological Disorders (1)
- Outcomes (1)
- Pregnancy (1)
- Primary Care (4)
- Primary Care: Models of Care (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Screening (10)
- Social Determinants of Health (2)
- Social Stigma (1)
- Women (2)
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 19 of 19 Research Studies DisplayedAdams LB, Baxter SLK, Lightfoot AF
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
This study’s goal was to look at why prevalence of depression is lower for Black males despite cumulative socioeconomic disadvantage and risk factors. For Black men, emotional vulnerability is often seen as a sign of weakness which may potentially mask the timely identification of mental health needs in this population. The authors use concept mapping, which is a structured mixed methods approach to determine how stakeholders of Black men’s health conceptualize their depressive symptoms. Thirty-six stakeholders comprised of Black men, Black women, and primary care providers participated in separate stakeholder groups in 2018. Participants generated 68 characteristics of Black men’s depression reflected in six conceptual clusters: 1) physical states; 2) emotional states; 3) diminished drive; 4) internal conflicts; 5) communication with others; and 6) social pressures. Using a content analysis approach, they found that items comprising the “social pressures” cluster were not reflected in any common depression scales.
AHRQ-funded; HS000032.
Citation: Adams LB, Baxter SLK, Lightfoot AF .
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
BMC Public Health 2021 Jun 22;21(1):1194. doi: 10.1186/s12889-021-11137-5..
Keywords: Men's Health, Racial and Ethnic Minorities, Depression, Behavioral Health, Diagnostic Safety and Quality
Levis B, Benedetti A, Ioannidis JPA
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
The authors compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. They found that PHQ-9 ≥10 substantially overestimated depression prevalence, as there was too much heterogeneity to correct statistically in individual studies.
AHRQ-funded; HS018246.
Citation: Levis B, Benedetti A, Ioannidis JPA .
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
J Clin Epidemiol 2020 Jun;122:115-28.e1. doi: 10.1016/j.jclinepi.2020.02.002..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Bolstad CJ, Moak R, Brown CJ
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
This study tested how neighborhood disadvantage (ND) relates to depressive symptomology and diagnosis to assess for neighborhood disparities in mental health care cross-sectionally. Using data from the University of Alabama at Birmingham Study of Aging, the investigators found living in the high and mid-ND tertiles to be associated with depressive symptomology, yet ND had no significant relation to depression diagnosis. They concluded that older adults living in high and mid-disadvantaged neighborhoods may be more likely to experience depressive symptomology but not receive a diagnosis, indicating a possible disparity in mental health care.
AHRQ-funded; HS013852.
Citation: Bolstad CJ, Moak R, Brown CJ .
Neighborhood disadvantage is associated with depressive symptoms but not depression diagnosis in older adults.
Int J Environ Res Public Health 2020 Aug 8;17(16). doi: 10.3390/ijerph17165745..
Keywords: Elderly, Depression, Behavioral Health, Diagnostic Safety and Quality, Disparities, Social Determinants of Health
Wu Y, Levis B, Riehm KE
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. In this study the investigators assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
AHRQ-funded; HS018246.
Citation: Wu Y, Levis B, Riehm KE .
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Psychol Med 2020 Jun;50(8):1368-80. doi: 10.1017/s0033291719001314..
Keywords: Diagnostic Safety and Quality, Depression, Behavioral Health, Screening
Munger Clary HM, Croxton RD, Allan J
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
This study assessed the willingness of epilepsy patients positively screened for anxiety and/or depression to participate in a research study. A total of 199 patients screened positively during a routine epilepsy screening visit and 154 (77.4%) opted-in for further research assessment. Nearly half of those 199 individuals were already being treated for anxiety and/or depression, with 46.7% receiving neither antidepressants or therapy. Higher depression scores and current treatment were independently associated with opting in. One-quarter reported a past psychiatric hospitalization, but only half of those individuals were currently receiving mental health specialty care.
AHRQ-funded; HS025723.
Citation: Munger Clary HM, Croxton RD, Allan J .
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
Epilepsy Behav 2020 Mar;104(Pt A):106907. doi: 10.1016/j.yebeh.2020.106907..
Keywords: Anxiety, Depression, Behavioral Health, Neurological Disorders, Chronic Conditions, Screening, Diagnostic Safety and Quality, Health Services Research (HSR), Research Methodologies
Klawetter S, McNitt C, Hoffman JA
Perinatal depression in low-income women: a literature review and innovative screening approach.
This paper is a literature review of perinatal depression prevalence, consequences, and screening among low-income women and women of color. The Warm Connections program has an innovative perinatal depression screening protocol and was used with WIC participants. The literature showed mixed findings of perinatal prevalence among low-income women and women of color. There were lower perinatal depression rates in the Warm Connections program in studies using less specific perinatal depression screening instruments with similar samples.
AHRQ-funded; HS026370.
Citation: Klawetter S, McNitt C, Hoffman JA .
Perinatal depression in low-income women: a literature review and innovative screening approach.
Curr Psychiatry Rep 2020 Jan 7;22(1):1. doi: 10.1007/s11920-019-1126-9.
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Keywords: Depression, Pregnancy, Women, Low-Income, Social Determinants of Health, Screening, Behavioral Health, Maternal Care, Disparities, Diagnostic Safety and Quality
Samples H, Stuart EA, Saloner B
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
This study aimed to examine depression screening patterns and the role of screening in depression diagnosis and treatment in the outpatient primary care setting. The investigators found that physicians appeared to use depression screening selectively based on patients' presenting symptoms. Higher screening rates were associated with higher odds of depression diagnosis and treatment. The investigators suggest that even modest increases in screening rates could meaningfully increase population-level rates of depression identification and treatment in primary care.
AHRQ-funded; HS000029.
Citation: Samples H, Stuart EA, Saloner B .
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
J Gen Intern Med 2020 Jan;35(1):12-20. doi: 10.1007/s11606-019-05192-3..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality, Primary Care, Screening, Ambulatory Care and Surgery
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
Adams LB, Gottfredson N, Lightfoot AF
Factor analysis of the CES-D 12 among a community sample of black men.
The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used measures for assessing depression in population-based research. This study assessed the dimensional structure of the CES-D 12-item scale using exploratory and confirmatory factor analysis in a community-based sample of Black men. Findings suggested that the "effort" item from the CES-D 12 should be interpreted with caution among Black men.
AHRQ-funded; HS000032.
Citation: Adams LB, Gottfredson N, Lightfoot AF .
Factor analysis of the CES-D 12 among a community sample of black men.
Am J Mens Health 2019 Mar-Apr;13(2):1557988319834105. doi: 10.1177/1557988319834105..
Keywords: Depression, Diagnostic Safety and Quality, Men's Health, Behavioral Health, Racial and Ethnic Minorities
Payan DD, Derose KP, Fulcar MA
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. In this study, the investigators conducted in-depth interviews with 30 women living with HIV in the Dominican Republic to explore the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings.
AHRQ-funded; HS000046.
Citation: Payan DD, Derose KP, Fulcar MA .
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18. doi: 10.1177/2325958219849042..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Women, Social Stigma, Depression, Behavioral Health
Ishihara M, Harel D, Levis B
Shortening self-report mental health symptom measures through optimal test assembly methods: development and validation of the Patient Health Questionnaire-Depression-4.
Researchers developed and validated a short form of the Patient Health Questionnaire-9 (PHQ-9) which assesses depression symptoms. This form was tested on 7,850 English-speaking patients enrolled in 20 diagnostic accuracy studies. The questions were optimized using Optimal test assembly (OTA) methods. Questionnaires from one to eight items were tried, with four questions found to be the optimal number with minimal loss of information compared to a full-length PHQ-9.
AHRQ-funded; HS018246.
Citation: Ishihara M, Harel D, Levis B .
Shortening self-report mental health symptom measures through optimal test assembly methods: development and validation of the Patient Health Questionnaire-Depression-4.
Depress Anxiety 2019 Jan;36(1):82-92. doi: 10.1002/da.22841..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health
Graham AK, Minc A, Staab E
Validation of the computerized adaptive test for mental health in primary care.
This study compared the use of a computerized assessment tool with paper questionnaires to diagnose major depressive disorder (MDD) and general anxiety disorder (GAD). It was found that the majority of patients in the study preferred the computerized adaptive testing tool. Diagnostic accuracy of the tool was similar or higher than many of the traditional screening methods.
AHRQ-funded; HS000078.
Citation: Graham AK, Minc A, Staab E .
Validation of the computerized adaptive test for mental health in primary care.
Ann Fam Med 2019 Jan;17(1):23-30. doi: 10.1370/afm.2316..
Keywords: Anxiety, Depression, Diagnostic Safety and Quality, Behavioral Health, Primary Care, Screening
Yin S, Connolly Gibbons MB, Diehl C
A self-report version of the ways of responding: reliability and validity in a clinical sample.
This study evaluated the reliability and validity of a modified, self-report version of the Ways of Responding instrument measures (WOR-SR) in a community mental health sample with depressive symptoms. Subjects completed the WOR-SR and other measures of depressive symptoms, dysfunctional cognitions, functioning, quality of life, and interpersonal problems at multiple time points. The authors conclude from their results that the WOR-SR is a reliable and valid measure of compensatory skills in patients receiving treatment for depression at community mental health centers.
AHRQ-funded; HS022124; HS018440.
Citation: Yin S, Connolly Gibbons MB, Diehl C .
A self-report version of the ways of responding: reliability and validity in a clinical sample.
Psychother Res 2018 Jul;28(4):581-92. doi: 10.1080/10503307.2016.1233367..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health, Outcomes
Levis B, Benedetti A, Riehm KE
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.
This study compared two interview methods that are used to diagnose depression in patients. It was found that the odds of diagnosing for depression were high for the Mini International Neuropsychiatric Interview (MINI) than the Composite International Diagnostic Interview (CIDI).
AHRQ-funded; HS018246.
Citation: Levis B, Benedetti A, Riehm KE .
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews.
Br J Psychiatry 2018 Jun;212(6):377-85. doi: 10.1192/bjp.2018.54..
Keywords: Depression, Diagnostic Safety and Quality, Behavioral Health
Olfson M, Blanco C, Marcus SC
Treatment of adult depression in the United States.
The researchers characterized the treatment of adult depression in the United States. They concluded that most US adults who screen positive for depression did not receive treatment for depression, whereas most who were treated did not screen positive. In light of these findings, it is important to strengthen efforts to align depression care with each patient's clinical needs.
AHRQ-funded; HS02112.
Citation: Olfson M, Blanco C, Marcus SC .
Treatment of adult depression in the United States.
JAMA Intern Med 2016 Oct;176(10):1482-91. doi: 10.1001/jamainternmed.2016.5057.
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Keywords: Medication, Depression, Diagnostic Safety and Quality, Medical Expenditure Panel Survey (MEPS)
Lewandowski RE, O'Connor B, Bertagnolli A
Screening for and diagnosis of depression among adolescents in a large health maintenance organization.
The researchers determined changes in patterns of depression screening and diagnosis over three years in primary and specialty mental health care in a large HMO. They found that the rate of depression screening in primary care increased over the study period, corresponding to an increase in the number of depression diagnoses made in primary care and a shift in the location in which depression diagnoses were made, from the mental health department to primary care.
AHRQ-funded; HS020503.
Citation: Lewandowski RE, O'Connor B, Bertagnolli A .
Screening for and diagnosis of depression among adolescents in a large health maintenance organization.
Psychiatr Serv 2016 Jun;67(6):636-41. doi: 10.1176/appi.ps.201400465.
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Keywords: Children/Adolescents, Depression, Diagnostic Safety and Quality, Behavioral Health, Screening