Therapy for depression can help minority women

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Both Antidepressant medication and cognitive behavior therapy is beneficial for poor, minority women suffering from major Depression, and it makes sense from a cost perspective too, according to new study findings.

“Treatment for depression is effective in low-income, minority women,” said Dr. Dennis A. Revicki. ”Depression treatments need to be tailored to specific populations to be most effective.”

Revicki, from the Center for Health Outcomes Research in Bethesda, Maryland, and his colleagues evaluated the costs and benefits of medication or cognitive behavior therapy (CBT) compared with community referral for major depression among 267 low-income minority women enrolled in the Women Entering Care (WECARE) trial.

"To our knowledge,” the investigators write in the Archives of General Psychiatry, “this study is the first to document the cost-effectiveness of mental health interventions tailored to engaging and treating an impoverished population.”

Only 17 percent of women in the community referral group actually attended a referral session or received any community care, the report indicates, and only 6 percent received antidepressants.

In contrast, the authors report, 75 percent of women in the medication group received at least 9 weeks of antidepressant treatment and 45 percent received at least 24 weeks of treatment as recommended by standard guidelines.

Just over half the CBT group participated in four or more therapy sessions, and 36 percent of the group attended at least six sessions.

Patients in both treatment groups had significantly more depression-free days during the 12-month follow-up than did women in the community referral group, the researchers note.

Compared with community referral, antidepressant therapy cost $24.65 per additional depression-free day, the investigators calculate. CBT cost slightly more, at $27.04, but both were relatively inexpensive in healthcare terms.

“Our findings suggest that expenditures for improved interventions for Depression in low-income minority women represent a good investment compared with a range of other generally acceptable medical treatments,” the authors conclude.

They recommend that “publicly financed health care systems should consider allocation of resources for depression treatment in low-income minority women.”

Revicki report about another result of the study. “During the WECARE study, we determined that many of the women had significant trauma histories and that interventions for trauma as well as Depression might be warranted,” he explained.

Also, a new center at Georgetown University Medical Center, Washington, DC, is being set up “to conduct research into interventions that might be effective and cost-effective in primary care and other settings.”

SOURCE: Archives of General Psychiatry, August 2005. 

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