title: The Effectiveness of Telepsychiatry-Based Culturally Sensitive Collaborative Treatment for Depressed Chinese American Immigrants: A Randomized Controlled Trial.
abstract: This study evaluates the effectiveness of a telepsychiatry-based culturally sensitive collaborative treatment (T-CSCT) intervention to improve treatment outcomes for depressed Chinese American immigrants.
  
  
  
  Participants were Chinese Americans recruited from primary care settings from February 1, 2009, to July 31, 2012, with DSM-IV major depressive disorder (MDD) identified by the Mini-International Neuropsychiatric Interview. Eligible patients were randomized to receive either T-CSCT or treatment as usual (TAU) for 6 months. T-CSCT involves (1) cultural consultation via videoconference and (2) care management. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS₁₇); positive response was defined as a ≥ 50% decrease in HDRS₁₇ score, and remission was defined as HDRS₁₇ score ≤ 7. Secondary outcome measures were the Clinical Global Impressions-Severity of Illness (CGI-S) and Improvement (CGI-I) scales and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Outcomes were compared using multivariate logistic regression and mixed-model for repeated measures methods.
  
  
  
  Among participants (N = 190), 63% were female, and the mean (SD) age was 50 (14.5) years. They were randomized to T-CSCT (n = 97; 51%) or TAU (n = 93; 49%). Using multivariate logistic regression analyses, the odds of achieving response and remission were significantly greater for the T-CSCT group compared to the control group (odds ratio [OR] = 3.9 [95% CI, 1.9 to 7.8] and 4.4 [95% CI, 1.9 to 9.9], respectively). Multivariate general linear model analyses showed that patients in the T-CSCT group had significantly greater improvement over time in HDRS₁₇ (F4,95 = 4.59, P = .002), CGI-S (F4,95 = 4.22, P = .003), and CGI-I (F4,95 = 2.95, P = .02) scores.
  
  
  
  T-CSCT is effective in improving treatment outcomes of Chinese immigrants with MDD.
  
  
  
  ClincialTrials.gov identifier: NCT00854542.
authors: Depression Clinical and Research Program, Massachusetts General Hospital, 1 Bowdoin Sq, Boston, MA 02114. ayeung@partners.org.|Depression Clinical and Research Program, Massachusetts General Hospital, Boston.|South Cove Community Health Center, Boston, Massachusetts, USA.
authors: Albert
authors: A
authors: Yeung
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Max A
authors: MA
authors: Martinson
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Lee
authors: L
authors: Baer
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Justin
authors: J
authors: Chen
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Alisabet
authors: A
authors: Clain
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Aya
authors: A
authors: Williams
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Trina E
authors: TE
authors: Chang
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Nhi-Ha T
authors: NH
authors: Trinh
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Jonathan E
authors: JE
authors: Alpert
authors: Depression Clinical and Research Program, Massachusetts General Hospital, Boston.
authors: Maurizio
authors: M
authors: Fava
mesh_terms: D000328:Adult; D000368:Aged; D001213:Asian; D065246:Culturally Competent Care / Q000379:methods*; D003865:Major Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D019468:Disease Management; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care; D012720:Severity of Illness Index; D017216:Telemedicine / Q000379:methods*; D014481:United States / Q000208:ethnology