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General medical and specialty mental health service use for major depression.

Publication ,  Journal Article
Burns, BJ; Ryan Wagner, H; Gaynes, BN; Wells, KB; Schulberg, HC
Published in: Int J Psychiatry Med
2000

OBJECTIVE: While major depression is common, many depressed persons receive, at best, inadequate treatment. A first step in remedying inadequate detection and treatment of major depression requires understanding the pathways into treatment-from situations of no care, to disease recognition, to referral and appropriate treatment-as well as identifying factors associated with movement between these several stages. METHODS: Using the Epidemiologic Catchment Area sample, we identified factors associated with treatment in the general medical or mental health specialist section, or no treatment in a subsample of individuals with current major depression. RESULTS: Strikingly, one-fourth of the sample received no services, over half received care in the general medical sector, and only one-fifth accessed a mental health specialist. Among those receiving any health services (general or mental), men and respondents reporting suicidal symptoms were at risk of receiving no care, while perceived poor health and a cluster of core depressive symptoms were associated with increased odds of service use (general or mental). Among respondents receiving general medical services, perceived poor health, core depressive symptoms, a history of depression, and comorbid mental conditions increased the odds of treatment in the specialty mental health sector. CONCLUSIONS: The findings emphasize the need for public health initiatives to 1) improve detection and movement into treatment among those at risk of receiving no care; and 2) insure that, once within the health care system, the processes of primary care treatment and specialty referrals conform to evidence-based treatment guidelines.

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Published In

Int J Psychiatry Med

DOI

ISSN

0091-2174

Publication Date

2000

Volume

30

Issue

2

Start / End Page

127 / 143

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Sampling Studies
  • Referral and Consultation
  • Recurrence
  • Psychiatry
  • Primary Health Care
  • Patient Acceptance of Health Care
  • Odds Ratio
  • Male
 

Citation

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Burns, B. J., Ryan Wagner, H., Gaynes, B. N., Wells, K. B., & Schulberg, H. C. (2000). General medical and specialty mental health service use for major depression. Int J Psychiatry Med, 30(2), 127–143. https://doi.org/10.2190/TLXJ-YXLX-F4YA-6PHA
Burns, B. J., H. Ryan Wagner, B. N. Gaynes, K. B. Wells, and H. C. Schulberg. “General medical and specialty mental health service use for major depression.Int J Psychiatry Med 30, no. 2 (2000): 127–43. https://doi.org/10.2190/TLXJ-YXLX-F4YA-6PHA.
Burns BJ, Ryan Wagner H, Gaynes BN, Wells KB, Schulberg HC. General medical and specialty mental health service use for major depression. Int J Psychiatry Med. 2000;30(2):127–43.
Burns, B. J., et al. “General medical and specialty mental health service use for major depression.Int J Psychiatry Med, vol. 30, no. 2, 2000, pp. 127–43. Pubmed, doi:10.2190/TLXJ-YXLX-F4YA-6PHA.
Burns BJ, Ryan Wagner H, Gaynes BN, Wells KB, Schulberg HC. General medical and specialty mental health service use for major depression. Int J Psychiatry Med. 2000;30(2):127–143.
Journal cover image

Published In

Int J Psychiatry Med

DOI

ISSN

0091-2174

Publication Date

2000

Volume

30

Issue

2

Start / End Page

127 / 143

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Sampling Studies
  • Referral and Consultation
  • Recurrence
  • Psychiatry
  • Primary Health Care
  • Patient Acceptance of Health Care
  • Odds Ratio
  • Male