The Impact of Posttraumatic Stress Disorder on the 6-Month Outcomes in Collaborative Care Management for Depression

Overview

Journal J Prim Care Community Health

Publisher Sage Publications

Specialty Health Services

Date 2016 Mar 20

PMID 26994060

Citations 5

Authors

Kurt B Angstman

Alberto Marcelin

Cesar A Gonzalez

Tara K Kaufman

Julie A Maxson

Mark D Williams

Affiliations

Soon will be listed here.

Abstract

Posttraumatic stress disorder (PTSD) has symptoms that exist along a spectrum that includes depression and the 2 disorders may coexist. Collaborative care management (CCM) has been successfully used in outpatient mental health management (especially depression and anxiety) with favorable outcomes. Despite this, there exist limited data on clinical impact of a diagnosis of PTSD on depression outcomes in CCM. The present study used a retrospective cohort design to examine the association of PTSD with depression outcomes among 2121 adult patients involved in CCM in a primary care setting. Using standardized self-report measures, baseline depression scores and 6-month outcome scores were evaluated. Seventy-six patients had a diagnosis of PTSD documented in their electronic medical record. Patients with PTSD reported more severe depressive symptoms at baseline (Patient Health Questionnaire-9 score of 17.9 vs 15.4, P < .001) than those without PTSD. Controlling for sociodemographic and clinical characteristics, a clinical diagnosis of PTSD was associated with lower odds (AOR = 0.457, CI = 0.274-0.760, P = .003) of remission at 6 months and was also associated with higher odds (AOR = 3.112, CI = 1.921-5.041, P < .001) of persistent depressive symptoms at 6 months after CCM. When coexisting with depression, a diagnosis of PTSD was associated with worse depression outcomes, when managed with CCM in primary care. Opportunities still exist for more aggressive management of depression in these patients to help improve remission as well as reduce persistent depressive symptoms.

Citing Articles

The Integration of Behavioral Health and Primary Care for Hispanic/Latino Patients with Depression and Comorbid PTSD.

Eghaneyan B, Killian M, Sanchez K J Behav Health Serv Res. 2022; 50(1):95-107.

PMID: 36352161 PMC: 9646280. DOI: 10.1007/s11414-022-09824-1.

Investigating post-traumatic stress disorder (PTSD) and complex PTSD among people with self-reported depressive symptoms.

Fung H, Chien W, Lam S, Ross C Front Psychiatry. 2022; 13:953001.

PMID: 36339839 PMC: 9627202. DOI: 10.3389/fpsyt.2022.953001.

The effect of co-morbid anxiety on remission from depression for people participating in a randomised controlled trial of the Friendship Bench intervention in Zimbabwe.

Abas M, Weiss H, Simms V, Verhey R, Rusakaniko S, Araya R EClinicalMedicine. 2020; 23:100333.

PMID: 32637890 PMC: 7329733. DOI: 10.1016/j.eclinm.2020.100333.

Impact of Personality Disorder Cluster on Depression Outcomes Within Collaborative Care Management Model of Care.

George M, Garrison G, Merten Z, Heredia Jr D, Gonzales C, Angstman K J Prim Care Community Health. 2018; 9:2150132718776877.

PMID: 29785866 PMC: 5967151. DOI: 10.1177/2150132718776877.

Personality Disorders in Primary Care: Impact on Depression Outcomes Within Collaborative Care.

Angstman K, Seshadri A, Marcelin A, Gonzalez C, Garrison G, Allen J J Prim Care Community Health. 2017; 8(4):233-238.

PMID: 28613090 PMC: 5932731. DOI: 10.1177/2150131917714929.

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