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Abstract

Objective

A culturally focused psychiatric (CFP) consultation service was implemented to increase engagement in mental health care and reduce depressive symptoms among adult Latino primary care patients. The aim of this study was to assess preliminary efficacy of the CFP consultation service to reduce depressive symptoms.

Methods

In a randomized controlled study, primary care clinics were randomly selected to provide either the two-session CFP intervention or enhanced usual care. For CFP intervention participants, study clinicians (psychologists or psychiatrists) provided a psychiatric assessment, psychoeducation, cognitive-behavioral tools, and tailored treatment recommendations; primary care providers were provided a consultation summary. Depressive symptoms (as measured by the Quick Inventory of Depressive Symptomatology–Self Rated [QIDS-SR]) were assessed at baseline and six-month follow-up. Multiple regression analysis was conducted to evaluate whether CFP intervention participants showed greater improvement in depressive symptoms at follow-up, with control for baseline depression, clinic site, and significant covariates.

Results

Participants (N=118) were primarily Spanish-monolingual speakers (64%). Although depressive symptoms remained in the moderate range for both groups from baseline to six months, symptom reduction was greater among CFP intervention participants (mean±SD change in QIDS-SR score=3.46±5.48) than those in usual care (change=.09±4.43). The final multiple regression model indicated that participation in the CFP intervention predicted lower depressive symptoms at follow-up (unstandardized beta=−3.09, p=.008), independent of baseline depressive symptoms, clinic site, age, gender, and employment status.

Conclusions

Results suggest that Latinos experiencing depressive symptoms may benefit from a short-term CFP consultation. Findings also support the integration of psychiatric interventions for Latinos in the primary care setting.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Shamrock Ranch, by Peter Hurd, 1962. Watercolor, 12 × 16 inches. New Mexico Museum of Art, Santa Fe. Gift of the family of Edythe C. Mattone, 2005.

Psychiatric Services
Pages: 1256 - 1262
PubMed: 24882225

History

Published online: 1 October 2014
Published in print: October 2014

Authors

Details

C. Andres Bedoya, Ph.D.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Lara Traeger, Ph.D.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Nhi-Ha T. Trinh, M.D., M.P.H.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Trina E. Chang, M.D., M.P.H.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Charlotte D. Brill, B.A.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Katherine Hails, B.A.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Patrick N. Hagan, B.A.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Katherine Flaherty, Sc.D.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.
Albert Yeung, M.D., Sc.D.
Dr. Bedoya, Dr. Traeger, Dr. Trinh, Dr. Chang, and Dr. Yeung are with Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Ms. Brill, Ms. Hails, and Mr. Hagan are with Massachusetts General Hospital. Dr. Flaherty is with Abt Associates Inc., Cambridge, Massachusetts. Send correspondence to Dr. Bedoya (e-mail: [email protected]). The findings were presented at the annual meeting and scientific sessions of the Society of Behavioral Medicine, San Francisco, March 20–23, 2013.

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