Background: Dramatic changes have occurred in mental health treatments during the past decade.Data on recent treatment patterns are needed to estimate unmet need for services.Objective: To provide data and predictors of 12-month United States from recently completed National Comorbidity Survey Replication.Design Setting: Nationally representative faceto-face household survey using a fully structured diagnostic interview,

We describe the functioning and well-being of patients with depression, relative to chronic medical conditions or no conditions. Data are from 11 242 outpatients in three health care provision systems US sites. Patients either current depressive disorder symptoms absence tended have worse physical, social, role functioning, perceived health, greater bodily pain than did The poor uniquely associated symptoms, without disorder, was comparable that eight major For example, unique association...

We describe the functioning and well-being of patients with depression, relative to chronic medical conditions or no conditions. Data are from 11 242 outpatients in three health care provision systems US sites. Patients either current depressive disorder symptoms absence tended have worse physical, social, role functioning, perceived health, greater bodily pain than did The poor uniquely associated symptoms, without disorder, was comparable that eight major For example, unique association...

Although the 1990s saw enormous change in mental health care system United States, little is known about changes prevalence or rate of treatment disorders.We examined trends and disorders among people 18 to 54 years age during roughly past decade. Data from National Comorbidity Survey (NCS) were obtained 5388 face-to-face household interviews conducted between 1990 1992, data NCS Replication 4319 2001 2003. Anxiety disorders, mood substance-abuse that present 12 months before interview...

OBJECTIVE: Policy discussions regarding the mental health needs of children and adolescents emphasize a lack use services among youth, but few national estimates are available. The authors three data sets examine ethnic disparities in unmet need (defined as having for evaluation not using any 1-year period) to provide such estimates. METHOD: conducted secondary analyses nationally representative household surveys fielded 1996–1998: National Health Interview Survey, Survey American Families,...

<h3>Context</h3> An understudied crucial step in the help-seeking process is making prompt initial contact with a treatment provider after first onset of mental disorder. <h3>Objective</h3> To provide data on patterns and predictors failure delay disorder United States from recently completed National Comorbidity Survey Replication. <h3>Design Setting</h3> Nationally representative face-to-face household survey carried out between February 2001 April 2003. <h3>Participants</h3> A total 9282...

<h3>Background</h3> Depressive and anxiety disorders are prevalent cause substantial morbidity. While effective treatments exist, little is known about the quality of care for these nationally. We estimated rate appropriate treatment among US population with disorders, effect insurance, provider type, individual characteristics on receipt care. <h3>Methods</h3> Data from a cross-sectional telephone survey conducted during 1997 1998 national sample. Respondents consisted 1636 adults probable...

ContextCare of patients with depression in managed primary care settings often fails to meet guideline standards, but the long-term impact quality improvement (QI) programs for such is unknown.ObjectiveTo determine if QI practices depressed improve care, health outcomes, and employment.DesignRandomized controlled trial initiated from June 1996 March 1997.SettingForty-six clinics 6 US organizations.ParticipantsOf 27,332 consecutively screened patients, 1356 current depressive symptoms either...

Background The aim was to examine barriers initiation and continuation of treatment among individuals with common mental disorders in the US general population. Method Respondents National Comorbidity Survey Replication 12-month DSM-IV mood, anxiety, substance, impulse control childhood were asked about perceived need for treatment, structural attitudinal/evaluative treatment. Results Low reported by 44.8% respondents a disorder who did not seek Desire handle problem on one's own most reason...

Objective: Prior work on racial/ethnic disparities in depression treatment has been limited by the scarcity of national samples that include an array diagnostic and quality indicators substantial non-English speaking minorities.Using nationally representative data (n=8762), we evaluate differences access to treatments between ethnic/racial minority patients non-Latino whites.Method: Access mental health care was assessed whether or not any received past year.Quality for acute defined as four...

The authors studied data on psychiatric disorders and eight chronic medical conditions in a community sample of 2,554 persons. sex- age-adjusted prevalence any disorder the preceding 6 months was 24.7% lifetime 42.2% among persons with one or more conditions, compared to 17.5% 33.0%, respectively, for no condition. Persons were likely have substance use recent affective anxiety disorders. Arthritis, cancer, lung disease, neurological disorder, heart physical handicap strongly associated...

THERE HAVE BEEN RECENT PRACTICE AND POLICY CONcerns over the “quality chasm,” or gap between promise of evidence-based medicine and realities community practice with little variation by geographic sociodemographic factors. Studies document disparities in access care for particular conditions, there is widespread concern about health status risk factors disadvantaging underserved ethnic minority lower-socioeconomic groups. Addressing quality gaps will require implementation programs to...

The authors' goal was to evaluate the association between impairment in daily function and subsyndromal depressive symptoms as well major depression determine economic societal significance of these conditions.Using 12-month prevalence data gathered by National Institute Mental Health (NIMH) Epidemiologic Catchment Area Program (ECA), based on responses NIMH Diagnostic Interview Schedule, authors divided 2,393 subjects from Los Angeles ECA site into three groups: with (N = 270), 102), no...

OBJECTIVE: Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD functioning quality of life remains incompletely understood. METHOD: The authors undertook an archival analysis data from National Vietnam Veterans Readjustment Study. study subjects consisted nationally representative sample male veterans who participated in estimated at time interview with Mississippi Scale for Combat-Related Posttraumatic Stress...

A very short (8-item), self-report measure was developed to screen for depressive disorders (major depression and dysthymia). The screener departs from traditional symptom scales in that 1) individual items are differentially weighted 2) two of the eight concern diagnostically relevant durations depressed mood. Analyses data a general population primary care mental health patients showed had high sensitivity good positive predictive value detecting disorder, especially recent those met full...

<h3>• Objective.—</h3> To compare the course of depression during a 2-year period in adult outpatients (n=626) with current major depression, dysthymia, and either both disorders ("double depression") or depressive symptoms no disorder. <h3>Methods.—</h3> Depressed patients visiting 523 clinicians (mental health specialists general medical providers) were identified using two-stage screening procedure including Diagnostic Interview Schedule. The was assessed 2 follow-up years structured...

Depression is a common condition associated with significant morbidity in adolescents. Few depressed adolescents receive effective treatment for depression primary care settings.To evaluate the effectiveness of quality improvement intervention aimed at increasing access to evidence-based treatments (particularly cognitive-behavior therapy and antidepressant medication), relative usual care, among practices.Randomized controlled trial conducted between 1999 2003 enrolling 418 patients current...

<h3>Background</h3> Use of opioids for chronic noncancer pain is increasing, but standards care this practice are poorly defined. Psychiatric disorders associated with increased physical symptoms such as and may be opioid use, no prospective population-based studies have addressed issue. <h3>Methods</h3> Analysis longitudinal data from 6439 participants in the 1998 2001 waves Healthcare Communities, a nationally representative telephone community survey. <h3>Results</h3> Two hundred...

We estimated clinicians' awareness of depression for patients with current depressive disorder (N = 650) who received care in either a single-specialty solo or small group practice, large multispecialty health maintenance organization three US sites. Depressive was determined by independent diagnostic assessment shortly after an office visit. Detection and treatment were from visit-report forms completed the treating clinician. Depending on setting, 78.2% to 86.9% depressed visited mental...