Archives of general psychiatry
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Arch. Gen. Psychiatry · Aug 2010
Randomized Controlled Trial Multicenter Study Comparative StudyCost-effectiveness analysis of a rural telemedicine collaborative care intervention for depression.
Collaborative care interventions for depression in primary care settings are clinically beneficial and cost-effective. Most prior studies were conducted in urban settings. ⋯ In rural settings, a telemedicine-based collaborative care intervention for depression is effective and expensive. The mean base case result was $85 634/QALY, which is greater than cost per QALY ratios reported for other, mostly urban, depression collaborative care interventions.
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Arch. Gen. Psychiatry · Jun 2010
Multicenter Study Comparative StudyA prospective cohort study investigating factors associated with depression during medical internship.
Although the prevalence of depression among medical interns substantially exceeds that of the general population, the specific factors responsible are not well understood. Recent reports of a moderating effect of a genetic polymorphism (5-HTTLPR) in the serotonin transporter protein gene on the likelihood that life stress will precipitate depression may help to understand the development of mood symptoms in medical interns. ⋯ There is a marked increase in depressive symptoms during medical internship. Specific individual, internship, and genetic factors are associated with the increase in depressive symptoms.
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Arch. Gen. Psychiatry · May 2010
Randomized Controlled Trial Multicenter StudyDaily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial.
Daily left prefrontal repetitive transcranial magnetic stimulation (rTMS) has been studied as a potential treatment for depression, but previous work had mixed outcomes and did not adequately mask sham conditions. ⋯ Daily left prefrontal rTMS as monotherapy produced statistically significant and clinically meaningful antidepressant therapeutic effects greater than sham.
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Arch. Gen. Psychiatry · Apr 2010
Multicenter StudyAssociation of polymorphisms in genes regulating the corticotropin-releasing factor system with antidepressant treatment response.
The corticotropin-releasing factor (CRF, or corticotropin-releasing hormone) and arginine vasopressin systems have been implicated in the pathophysiology of anxiety and depressive disorders and response to antidepressant treatment. ⋯ These data indicate that a genetic variant within the CRHBP locus affects response to citalopram in African American and Hispanic patients, suggesting a role for this gene and for the CRF system in antidepressant treatment response.
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Arch. Gen. Psychiatry · Oct 2009
Randomized Controlled Trial Multicenter StudyIncremental benefit and cost of telephone care management and telephone psychotherapy for depression in primary care.
Effectiveness of organized depression care programs is well established, but dissemination will depend on the balance of benefits and costs. ⋯ Compared with current primary care practice, a structured telephone program including care management and cognitive behavioral psychotherapy has significant clinical benefit with only a modest increase in health services cost.