title: Women Veterans with Depression in Veterans Health Administration Primary Care: An Assessment of Needs and Preferences.
abstract: Depression is the most prevalent mental health condition in primary care (PC). Yet as the Veterans Health Administration increases resources for PC/mental health integration, including integrated care for women, there is little detailed information about depression care needs, preferences, comorbidity, and access patterns among women veterans with depression followed in PC.
  
  
  
  We sampled patients regularly engaged with Veterans Health Administration PC. We screened 10,929 (10,580 men, 349 women) with the two-item Patient Health Questionnaire. Of the 2,186 patients who screened positive (2,092 men, 94 women), 2,017 men and 93 women completed the full Patient Health Questionnaire-9 depression screening tool. Ultimately, 46 women and 715 men with probable major depression were enrolled and completed a baseline telephone survey. We conducted descriptive statistics to provide information about the depression care experiences of women veterans and to examine potential gender differences at baseline and at seven month follow-up across study variables.
  
  
  
  Among those patients who agreed to screening, 20% of women (70 of 348) had probable major depression, versus only 12% of men (1,243 of 10,505). Of the women, 48% had concurrent probable posttraumatic stress disorder and 65% reported general anxiety. Women were more likely to receive adequate depression care than men (57% vs. 39%, respectively; p < .05); 46% of women and 39% of men reported depression symptom improvement at the 7-month follow-up. Women veterans were less likely than men to prefer care from a PC physician (p < .01) at baseline and were more likely than men to report mental health specialist care (p < .01) in the 6 months before baseline.
  
  
  
  PC/mental health integration planners should consider methods for accommodating women veterans unique care needs and preferences for mental health care delivered by health care professionals other than physicians.
authors.affiliation: VA Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; University of California, Los Angeles School of Medicine, Division of Psychiatry and Behavioral Sciences-Semel Institute, Los Angeles, California. Electronic address: davis127@yahoo.com.
authors.forename: Teri D
authors.initials: TD
authors.lastname: Davis
authors.affiliation: University of Montana, Department of Psychology, Missoula, Montana.
authors.forename: Duncan G
authors.initials: DG
authors.lastname: Campbell
authors.affiliation: VA HSR&D Northwest Center for Outcomes Research in Older Adults, VA Puget Sound Healthcare System, & Geriatric Research, Education and Clinical Center (GRECC), Seattle, Washington; University of Washington, Department of Psychiatry & Behavioral Sciences, Seattle, Washington.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Bonner
authors.affiliation: Washington State University Vancouver, Department of Human Development, Vancouver, Washington.
authors.forename: Cory R
authors.initials: CR
authors.lastname: Bolkan
authors.affiliation: VA Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lanto
authors.affiliation: University of Washington, Department of Psychiatry & Behavioral Sciences, Seattle, Washington.
authors.forename: Edmund F
authors.initials: EF
authors.lastname: Chaney
authors.affiliation: Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan; Center for Clinical Management Research, Health Services Research and Development Service, VA Ann Arbor Health Care System, Ann Arbor, Michigan.
authors.forename: Thomas
authors.initials: T
authors.lastname: Waltz
authors.affiliation: Center for Clinical Management Research (CCMR), VA Ann Arbor Medical Center, Ann Arbor, Michigan; University of Michigan Medical School, Department of Psychiatry, Ann Arbor, Michigan.
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
authors.affiliation: VA Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; University of California, Los Angeles School of Public Health, Department of Health Services, Los Angeles, California.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Yano
authors.affiliation: VA Health Services Research & Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California; University of California, Los Angeles School of Medicine, Division of General Internal Medicine and Health Services Research, Los Angeles, California; RAND Health Program, RAND Corporation, Santa Monica, California.
authors.forename: Lisa V
authors.initials: LV
authors.lastname: Rubenstein
mesh_terms: D000328:Adult; D003863:Depression / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D020380:Needs Assessment; D063868:Patient Outcome Assessment; D057240:Patient Preference; D017060:Patient Satisfaction; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*; D058014:Veterans Health