期刊
JOURNAL OF AFFECTIVE DISORDERS
卷 283, 期 -, 页码 11-19出版社
ELSEVIER
DOI: 10.1016/j.jad.2021.01.033
关键词
Depression; Primary Care; Intervention; Veterans; RCT; Behavioral Activation
资金
- Health Services Research and Development Service grant [IIR 14-047-1]
- VA Center of Excellence for Suicide Prevention pilot grant
- Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service (HSR&D) as a VA HSR&D Career Development at the Center for Integrated Healthcare [15-262]
This study indicates that while both groups showed a reduction in depressive symptoms within 12 weeks, the BA-PC group demonstrated significant improvements in quality of life and mental health functioning.
Background: Behavioral activation is ideal for embedded behavioral health providers (BHPs) working in primary care settings treating patients reporting a range of depressive symptoms. The current study tested whether a brief version of Behavioral Activation (two 30-minute appointments, 2 boosters) designed for primary care (BA-PC) was more effective than primary care behavioral health treatment-as-usual (TAU) in reducing depressive symptoms and improving quality of life and functioning. Methods: Parallel-arm, multi-site randomized controlled trial. 140 Veterans were randomized to BA-PC or TAU and completed assessments at baseline, 6 weeks, 12 weeks, and 24 weeks. Results: Reductions in depressive symptoms were observed in both groups between baseline and 3-weeks prior to any treatment, with continued reductions among those in the BA-PC condition through 12-weeks. However, there was no significant condition X time interaction at 12-weeks. Quality of life and mental health functioning were significantly improved for those in the BA-PC condition, compared to TAU, at 12 weeks. Limitations: Generalizability to a broader population may be limited as this sample consisted of veterans. Although engagement in TAU matched other prior work, it was lower than engagement in BA-PC, which also may compromise results. Conclusions: Although this study found that both TAU and BA-PC participants showed a decline in depressive symptoms, improvements in functioning and quality of life within those assigned to BA-PC, strong treatment retention and feasibility of BA-PC, and significant reductions in depressive symptoms among those with more severe baseline depressive symptoms are encouraging and support continued research on BA-PC. This trial was registered in clinicaltrials.gov as Improving Mood in Veterans in Primary Care (NCT02276807).
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