title: Augmenting Ongoing Depression Care With a Mutual Peer Support Intervention Versus Self-Help Materials Alone: A Randomized Trial.
abstract: OBJECTIVE
  Various models of peer support may be implemented in mental health settings. This randomized trial assessed the effectiveness of a telephone-delivered mutual peer support intervention.
  
  
  METHODS
  A total of 443 patients receiving ongoing depression treatment from the U.S. Department of Veterans Affairs were enrolled in either enhanced usual care (N=243) or the peer support intervention (N=200). Intent-to-treat analyses assessed outcomes at six months postenrollment, excluding 56 patients who experienced an unplanned telephone platform shutdown.
  
  
  RESULTS
  At baseline, patients had substantial depressive symptoms, functional limitations, and low quality of life. Both groups showed significant clinical improvements at six months, with no significant differences by group.
  
  
  CONCLUSIONS
  Telephone-delivered mutual peer support for patients with depression did not improve outcomes beyond those observed with enhanced usual care. Other peer support models, with more "professionalized" peers delivering a structured curriculum, may be more effective.
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Marcia
authors.initials: M
authors.lastname: Valenstein
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Pfeiffer
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Samantha
authors.initials: S
authors.lastname: Brandfon
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Heather
authors.initials: H
authors.lastname: Walters
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Dara
authors.initials: D
authors.lastname: Ganoczy
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Jay L
authors.initials: JL
authors.lastname: Cohen
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Winnetha
authors.initials: W
authors.lastname: Benn-Burton
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Elaine
authors.initials: E
authors.lastname: Carroll
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Henry
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Garcia
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Brittany
authors.initials: B
authors.lastname: Risk
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Helen C
authors.initials: HC
authors.lastname: Kales
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: John D
authors.initials: JD
authors.lastname: Piette
authors.affiliation: Dr. Valenstein, Dr. Pfeiffer, Ms. Walters, and Dr. Kales are with the Department of Psychiatry, University of Michigan Medical School, Ann Arbor (e-mail: marciav@umich.edu ). They are also with the Department of Veterans Affairs (VA), VA Center for Clinical Management Research, Ann Arbor, where Ms. Brandfon, Ms. Ganoczy, Dr. Kim, Ms. Henry, Ms. Garcia, Ms. Risk, and Dr. Piette are affiliated. Dr. Kim is also affiliated with the Center for Statistical Consultation and Research, University of Michigan, Ann Arbor. Dr. Piette is also with the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, where Dr. Heisler is affiliated. Dr. Cohen is with the Department of Psychiatry, VA Medical Center, Battle Creek, Michigan. Dr. Benn-Burton is with the Department of Psychiatry, VA Medical Center, Detroit, Michigan. Dr. Carroll is with the Department of Psychiatry, VA Medical Center, Saginaw, Michigan.
authors.forename: Michele
authors.initials: M
authors.lastname: Heisler
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003376:Counseling; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D011613:Psychotherapy; D012648:Self Care; D012944:Social Support; D013689:Telephone; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D000928:Antidepressive Agents