Step by Step

INTRODUCTION

Assessment and Treatment of Major Depression, with a focus on special populations

QUIZ

EVALUATION

CERTIFICATE

INTRODUCTION

Credit Hours: CME 1.00

Target Audience:

Faculty, residents, fellows, and primary care physicians.

Educational Objectives:

Upon completion of this activity, participants should be able to:

  • Recognize the role of collaborative, measurement based care in improving depression treatment outcomes, especially among the elderly to improve the ability to manage depression in the primary care setting through regular use of instruments to measure symptom burden and to utilize the collaborative care mode.
  • Recognize the risk and benefits of using pharmacological interventions during pregnancy to manage behavioral health issues to increase knowledge regarding safe use of medication during pregnancy.

Suggested Additional Reading:

  1. Bruce et al. Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. JAMA.2004 Mar 3;291(9):1081-91; Unutzer et al. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA.2002;288(22):2836-45. ; Prady SL, Hanlon I, Fraser LK, et al: A systematic review of maternal antidepressant use in pregnancy and short- and long-term offspring's outcomes. Arch Womens Ment Health. 2018 Apr;21(2):127-140.
  2. PHQ-9
  3. Kroenke K, Spitzer RL, Williams JB: The PHQ-9 Validity of a Brief Depression Severity Measure. J Gen Intern Med. 2001 Sep; 16(9): 606–613.
  4. COLLABORATIVE, MEASUREMENT BASED, STEPPED CARE
  5. Bruce et al. Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. JAMA.2004 Mar 3;291(9):1081-91 [PROSPECT]
  6. Unutzer et al. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA.2002;288(22):2836-45. [IMPACT]
  7. Trivedi MH, Rush AJ, Crismon ML, et al. Clinical results for patients with major depressive disorder in the Texas Medication Algorithm Project. Arch Gen Psychiatry. 2004;61:669-680. [TEXAS]
  8. Trivedi MH, Rush AJ, Wisniewski SR, et al. Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. Am J Psychiatry. 2006;163:28-40. [STAR*D]
  9. American Psychiatric Association Practice Guideline for the Treatment of Patients With Major Depressive Disorder, Third Edition, originally published in October 2010.
  10. COGNITION AND DEPRESSION
  11. Gallagher D, Kiss A, Lanctot KL, Herrmann N.Toward Prevention of Mild Cognitive Impairment in Older Adults With Depression: An Observational Study of Potentially Modifiable Risk Factors. J Clin Psychiatry. 2018 Nov 27;80(1).
  12. Bhalla RK, Butters MA, Mulsant BH, et al: Persistence of neuropsychologic deficits in the remitted state of late-life depression. Am J Geriatr Psychiatry. 2006 May;14(5):419-27.
  13. MATERNAL ANTIDEPRESSANT USE
  14. Prady SL, Hanlon I, Fraser LK, Mikocka-Walus A: A systematic review of maternal antidepressant use in pregnancy and short- and long-term offspring's outcomes. Arch Womens Ment Health. 2018 Apr;21(2):127-140.
  15. Uguz F. Maternal Antidepressant Use During Pregnancy and the Risk of Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review of the Current Literature. J Clin Psychopharmacol. 2018 Jun;38(3):254-259

Authors:
Ellen M. Whyte, MD — Medical Director, Psychiatric Services, UPMC Benedum Geriatric Center
No relationships with industry relevant to the content of this educational activity have been disclosed.
Authors disclosure of relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients is listed above. No other planners, members of the planning committee, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits. Each physician should only claim credit commensurate with the extent of their participation in the activity.

The University of Pittsburgh is an affirmative action, equal opportunity institution.