Treatment of depression among impoverished primary care patients from ethnic minority groups

Psychiatr Serv. 2003 Feb;54(2):219-25. doi: 10.1176/


Objective: The aim of this study was to determine whether supplementing traditional cognitive-behavioral therapy for depression with clinical case management would reduce the rate of dropout from care and improve outcomes for ethnically diverse, impoverished medical outpatients.

Methods: The study was a randomized trial that compared cognitive-behavioral group psychotherapy alone (N=103) with the same therapy supplemented by clinical case management (N=96).

Results: The patients who received supplemental case management had lower dropout rates than those who received cognitive-behavioral group therapy alone. Supplemental case management was associated with greater improvement in symptoms and functioning than cognitive-behavioral therapy alone for patients whose first language was Spanish (N=77) but was less effective for those whose first language was English (N=122).

Conclusions: Supplemental case management improves retention in traditional mental health outpatient care and can improve outcomes for Spanish-speaking patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • California
  • Case Management*
  • Cognitive Behavioral Therapy*
  • Culture
  • Depressive Disorder, Major / ethnology*
  • Depressive Disorder, Major / therapy*
  • Female
  • Hispanic Americans / psychology
  • Humans
  • Male
  • Minority Groups / psychology*
  • Patient Dropouts / psychology
  • Patient Dropouts / statistics & numerical data*
  • Poverty
  • Primary Health Care*
  • Psychotherapy, Group*
  • Treatment Outcome
  • United States
  • Vulnerable Populations / psychology*