Treatment of depression among impoverished primary care patients from ethnic minority groups.
OBJECTIVE
The aim of this study was to determine whether supplementing traditional cognitive-behavioral therapy for depression with clinical case management would reduce the rate of dropout from care and improve outcomes for ethnically diverse, impoverished medical outpatients.


METHODS
The study was a randomized trial that compared cognitive-behavioral group psychotherapy alone (N=103) with the same therapy supplemented by clinical case management (N=96).


RESULTS
The patients who received supplemental case management had lower dropout rates than those who received cognitive-behavioral group therapy alone. Supplemental case management was associated with greater improvement in symptoms and functioning than cognitive-behavioral therapy alone for patients whose first language was Spanish (N=77) but was less effective for those whose first language was English (N=122).


CONCLUSIONS
Supplemental case management improves retention in traditional mental health outpatient care and can improve outcomes for Spanish-speaking patients.
Miranda
Jeanne
J
San Francisco General Hospital, University of California, USA. mirandaj@ucla.edu
Azocar
Francisca
F
Organista
Kurt C
KC
Dwyer
Eleanor
E
Areane
Patricia
P
D000328:Adult; D002140:California; D019090:Case Management; D015928:Cognitive Behavioral Therapy; D003469:Culture; D003865:Major Depressive Disorder / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D011203:Poverty; D011320:Primary Health Care; D011615:Psychotherapy, Group; D016896:Treatment Outcome; D014481:United States; D035862:Vulnerable Populations / Q000523:psychology*