Category Archives: PLoS One

Related Articles

The effects of a problem solving-based intervention on depressive symptoms and HIV medication adherence are independent.

PLoS One. 2014;9(1):e84952

Authors: Gross R, Bellamy SL, Chapman J, Han X, O’Duor J, Strom BL, Houts PS, Palmer SC, Coyne JC

Abstract
Depression and depressive symptoms predict poor adherence to medical therapy, but the association is complex, nonspecific, and difficult to interpret. Understanding this association may help to identify the mechanism explaining the results of interventions that improve both medical therapy adherence and depressive symptoms as well as determine the importance of targeting depression in adherence interventions. We previously demonstrated that Managed Problem Solving (MAPS) focused on HIV medication adherence improved adherence and viral load in patients initiating a new antiretroviral regimen. Here, we assessed whether MAPS improved depressive symptoms and in turn, whether changes in depressive symptoms mediated changes in adherence and treatment outcomes. We compared MAPS to usual care with respect to presence of depressive symptoms during the trial using logistic regression. We then assessed whether MAPS’ effect on depressive symptoms mediated the relationship between MAPS and adherence and virologic outcomes using linear and logistic regression, respectively. Mediation was defined by the disappearance of the mathematical association between MAPS and the outcomes when the proposed mediator was included in regression models. Although MAPS participants had a lower rate of depressive symptoms (OR = 0.45, 95% confidence interval 0.21-0.93), there was no evidence of mediation of the effects of MAPS on adherence and virological outcome by improvements in depression. Thus, interventions for medication adherence may not need to address depressive symptoms in order to impact both adherence and depression; this remains to be confirmed, however, in other data.

PMID: 24400124 [PubMed – indexed for MEDLINE]

Continue reading →

Related Articles
Problems in cross-cultural use of the hospital anxiety and depression scale: “no butterflies in the desert”.
PLoS One. 2013;8(8):e70975
Authors: Maters GA, Sanderman R, Kim AY, Coyne JC
Abst… Continue reading →

Related Articles
Does evidence support the American Heart Association’s recommendation to screen patients for depression in cardiovascular care? An updated systematic review.
PLoS One. 2013;8(1):e52654
Authors: Thombs BD, Ros… Continue reading →

Related Articles

Depression screening and patient outcomes in cancer: a systematic review.

PLoS One. 2011;6(11):e27181

Authors: Meijer A, Roseman M, Milette K, Coyne JC, Stefanek ME, Ziegelstein RC, Arthurs E, Leavens A, Palmer SC, Stewart DE, de Jonge P, Thombs BD

Abstract
BACKGROUND: Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer patients by assessing the (1) accuracy of depression screening tools; (2) effectiveness of depression treatment; and (3) effect of depression screening, either alone or in the context of comprehensive depression care, on depression outcomes.
METHODS: Data sources were CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO and SCOPUS databases through January 24, 2011; manual journal searches; reference lists; citation tracking; trial registry reviews. Articles on cancer patients were included if they (1) compared a depression screening instrument to a valid criterion for major depressive disorder (MDD); (2) compared depression treatment with placebo or usual care in a randomized controlled trial (RCT); (3) assessed the effect of screening on depression outcomes in a RCT.
RESULTS: There were 19 studies of screening accuracy, 1 MDD treatment RCT, but no RCTs that investigated effects of screening on depression outcomes. Screening accuracy studies generally had small sample sizes (median = 17 depression cases) and used exploratory methods to set sample-specific cutoff scores that varied substantially across studies. A nurse-delivered intervention for MDD reduced depressive symptoms moderately (effect size = 0.37).
CONCLUSIONS: The one treatment study reviewed reported modest improvement in depressive symptoms, but no evidence was found on whether or not depression screening in cancer patients, either alone or in the context of optimal depression care, improves depression outcomes compared to usual care. Depression screening in cancer should be evaluated in a RCT in which all patients identified as depressed, either through screening or via physician recognition and referral in a control group, have access to comprehensive depression care.

PMID: 22110613 [PubMed – indexed for MEDLINE]

Continue reading →