The Collaborative Care Model (CoCM), in which social workers, primary care physicians, and a consulting psychiatrist work as a team, is an established approach to the treatment of common mental health conditions in primary care settings. Following implementation of a CoCM depression care program at our hospital-based academic primary care practice, we observed a low rate of retention with the use of problem solving therapy/behavioral activation (PST/BA). Our aim in this study was to evaluate the effectiveness of interpersonal psychotherapy (IPT), an evidence-based, flexible strategy that focuses on the relationship between depression and interpersonal challenges, compared to PST/BA. In 2015, most patients enrolled in our CoCM received PST/BA. In 2016, most patients received IPT. Patients who were enrolled and discharged from our CoCM depression care program in the years 2015 and 2016 and received either PST/BA or IPT, were included. Our primary measure was the difference in change in PHQ-9 score between the PST/BA and the IPT groups. Secondary outcomes included the difference in the change in GAD-7 score and measures of glycemic and blood pressure control between the two groups. Two hundred thirty four patients were included in our analysis. One hundred sixty five received PST/BA and 69 received IPT. There was no difference between groups in baseline demographics or measures of depression, anxiety, presence of hypertension, or presence of prediabetes/diabetes. Our primary analysis demonstrated a greater decrease in PHQ-9 score in patients receiving IPT (9.93) compared to those receiving PST/BA (5.41) ( p < 0.0001). The proportion of patients achieving a clinical response (PHQ-9 < 10) was also greater in the IPT group (71%) compared to the PST/BA group (44%). In a CoCM depression care program, IPT was a more effective strategy in improving depression symptoms as measured by PHQ-9 scores than PST/BA.

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抑郁症护理的新方法：在大型城市初级保健环境中适应人际治疗的功效

协作护理模式 (CoCM)，其中社会工作者、初级保健医生和咨询精神科医生作为一个团队工作，是治疗初级保健环境中常见心理健康状况的既定方法。在我们基于医院的学术初级保健实践中实施 CoCM 抑郁症护理计划后，我们观察到使用问题解决疗法/行为激活 (PST/BA) 的保留率较低。我们在本研究中的目的是评估人际心理治疗 (IPT) 的有效性，这是一种基于证据的灵活策略，侧重于抑郁症和人际挑战之间的关系，与 PST/BA 相比。2015 年，参加我们 CoCM 的大多数患者都接受了 PST/BA。2016 年，大多数患者接受了 IPT。包括在 2015 年和 2016 年从我们的 CoCM 抑郁症护理计划入组和出院并接受 PST/BA 或 IPT 的患者。我们的主要衡量指标是 PST/BA 和 IPT 组之间 PHQ-9 评分变化的差异。次要结局包括两组间 GAD-7 评分变化以及血糖和血压控制指标的差异。我们的分析中包括 234 名患者。165 人接受了 PST/BA，69 人接受了 IPT。在基线人口统计学或抑郁、焦虑、高血压或前驱糖尿病/糖尿病的测量方面，各组之间没有差异。我们的初步分析表明，与接受 PST/BA (5.41) 的患者相比，接受 IPT (9.93) 的患者的 PHQ-9 评分下降幅度更大（p < 0.0001）。与 PST/BA 组 (44%) 相比，IPT 组 (71%) 实现临床反应 (PHQ-9 < 10) 的患者比例也更高。在 CoCM 抑郁症护理计划中，IPT 是一种更有效的改善抑郁症症状的策略，以 PHQ-9 评分衡量，而不是 PST/BA。