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Patient's weight 6 months after depression treatment is not affected by either clinical remission or enrolment in collaborative care management

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Abstract:

Objective: The primary aim of this study was to determine whether enrolment in collaborative care management (CCM) for treatment of major depression would have a significant impact on 6month changes in weight compared with patients treated by their primary care provider with usual care. The secondary aim was to determine whether clinical remission would also affect 6-month weight changes.

Design: A retrospective chart review study included 1550 patients who had been diagnosed with major depression or dysthymia and who had a Patient Health Questionnaire (PHQ-9) score of ≥ 10 with follow-up data (PHQ-9 score and weight) at 6 months.

Subjects: The study sample consisted of adult patients (aged ≥ 18 years) from primary care practices, representing all body mass index (BMI) categories. The exclusion criteria were a diagnosis of bipolar disorder, recent obstetric delivery or recent gastric bypass procedure.

Measurements: Weight was measured at index and 6 months, with BMI calculated from electronic medical record data. Patient assessment data (including PHQ-9 score and clinical diagnosis) and demographic variables (age, gender, marital status and clinical location) were also collected.

Results: With regression modelling, neither enrolment in CCM (P = 0.306) nor clinical remission (P = 0.828) was associated with a significant weight gain.

Conclusion: After 6 months, enrolment in CCM had no significant impact on weight gain or weight loss among patients treated for depression, nor was improvement to clinical remission a factor in the patient's weight after 6 months. Incorporating a weight loss management intervention within the model may be warranted if concomitant weight reduction is desired.

Keywords: COLLABORATIVE CARE MANAGEMENT; DEPRESSION; OBESITY; PRIMARY CARE

Document Type: Research Article

Affiliations: 1: Department of Family Medicine, 200 First Street, SW Rochester, MN 55905, USA;, Email: angstman.kurt@mayo.edu 2: Department of Family Medicine, Mayo Clinic, Rochester, MN, USA 3: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA 4: Department of Family Medicine, Mayo Clinic Health System- Austin, Austin, MN, USA

Publication date: August 1, 2013

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