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Ambulatory Assessment of Depression in Primary Care

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Technical Report

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Uniformed Services University Of The Health Sciences Bethesda United States

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Depression is common among individuals in primary care. Despite the prevalence of depression in primary care, patients are usually not adequately treated for depression. Often the treatment that is received is generally limited to their specific medical condition and depression is either not treated or is inadequately treated. Self-monitoring is used in research and treatment settings to monitor physical, behavioral, and psychological changes. Previous research has suggested that depression may be reactive to self-monitoring, in that mood, physical activity, and other depressive symptoms often improve when individuals monitor their behaviors and depressive symptoms. Current studies have noted impact on outcomes including improved adherence and symptom improvement based on the type of monitoring. The present study investigated self-monitoring of major depressive disorder symptoms and treatment adherence in a primary care setting. The study was designed to evaluate three main questions. Does computer-based or paper-and-pencil monitoring result in greater compliance with reporting of mood symptoms and adherence to medication in treatment of depression Do participants who monitor depressive symptoms have better outcomes of depression treatment than those who do not monitor symptoms Which symptom cluster of depression cognitive-affective or physical will improve first during the four-week course of the study Individuals enrolled in primary care at Walter Reed Army Medical Center, were diagnosed by their primary care provider with depression, and placed on anti-depressant medication participated in the study n17. Once enrolled, individuals completed self-report measures and interviews of general health status, psychological symptoms, and physical symptoms. Individuals were randomly assigned to one of three groups control, computer-based, or pencil-and-paper based monitoring.

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