Culturally sensitive collaborative treatment for depressed chinese americans in primary care

Abstract

Objectives: We examined the feasibility and effectiveness of using culturally sensitive collaborative treatment (CSCT) to improve recognition, engagement, and treatment of depressed Chinese Americans in primary care.

Methods: Chinese American patients in a primary care setting (n = 4228) were screened for depression. The primary study outcome was treatment engagement rate, and the secondary outcome was treatment response.

Results: Of the study participants, 296 (7%) screened positive for depression, 122 (41%) of whom presented for a psychiatric assessment; 104 (85%) were confirmed with major depressive disorder, and 100 (96%) of these patients were randomized into treatment involving either care management or usual care. Patients in the care management and usual care groups did not differ in terms of their outcomes. CSCT resulted in a nearly 7-fold increase in treatment rate among depressed patients in primary care.

Conclusions: CSCT is both feasible and effective in improving recognition and treatment engagement of depressed Chinese Americans. Care management may have limited effects on depressed patients treated by psychiatrists, given that these patients tend to have favorable responses in general.

FIGURE 1

Recognition and treatment engagement outcomes of culturally sensitive collaborative treatment of depressed Chinese Americans in primary care: Boston, MA, 2004–2007. Note. CB-PHQ-9 = Chinese Bilingual Patient Health Questionnaire-9; MDD = major depressive disorder.