FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1505747863> ?p ?o ?g. }

• W1505747863 abstract "Depression is a condition with various modes of treatment, including pharmacotherapy, psychotherapy, and some combination of each. The role of psychotherapy in the treatment of depression relative to the role of pharmacotherapy is not well understood, and guidelines for psychotherapy in the primary care setting differ from guidelines for specialty care. There is little evidence about the circumstances in actual practice that affect the use of psychotherapy in conjunction with pharmacotherapy. We retrospectively identify the most important factors associated with the use of psychotherapy in combination with pharmacotherapy in the treatment of depression. Specifically, we study provider choice, health plan characteristics, and patient characteristics. We use a comprehensive medical and pharmacy claims data sample of 1,023 individuals during 1992-1994. We select persons prescribed with an antidepressant medication and diagnosed with a depressive disorder by a primary care physician, psychiatrist, or non-physician mental health specialist. Controlling for depression diagnosis and severity, comorbidity, and demographics, we examine the role of provider type and plan benefit characteristics. We study the intensity of psychotherapy using zero-inflated count regression, the intensity of pharmacotherapy using truncated count regression, and the likelihood of relapse of depression using logistic regression. Patients initially seeing a psychiatrist receive more than double the amount of psychotherapy and slightly more pharmacotherapy than patients of other providers. An additional prescription for antidepressant medication reduces by five percent the likelihood of relapse into depression, but the amount of psychotherapy does not affect relapse. Patients seeing a psychiatrist are half as likely to relapse, independent of any effect of psychotherapy. Case management and coinsurance rates do not affect the amount of psychotherapy, but the presence of case management has a positive effect on the amount of pharmacotherapy and on the likelihood of relapse. We find no discernible pattern of complementarity or substitution between pharmacotherapy and psychotherapy across providers. Although the amount of psychotherapy provided in conjunction with medication does not affect the rate of relapse to depression, psychotherapy may nonetheless provide beneficial outcomes not studied here. Choice of a psychiatrist reduces the likelihood of relapse, independent of the number of psychotherapy sessions and antidepressant prescriptions. The effect of provider choice on relapse could be an artifact of differences in provider follow-up practices or could represent a difference in provider skills. Managed care strategies do not appear to reduce the intensity of depression treatment, but case management does increase the likelihood of relapse. Pharmacotherapy and psychotherapy appear to be neither substitutes nor complements in the treatment of depression, suggesting that treatment is individualized. Choice of psychiatrist as the initial provider appears to reduce the likelihood of relapse, suggesting models of coordinated care may be beneficial. The link between psychiatrists and more psychotherapy is consistent with the hypothesis that patients resistant to treatment may nonetheless receive high quality care. Managed care tools such as case management and coinsurance rates do not appear to restrict the use of either psychotherapy or pharmacotherapy. The association of case management with an increased likelihood of relapse suggests that plan characteristics can affect outcomes. Our study focuses on psychotherapy combined with medication and does not psychotherapy alone in the treatment of depression, which may be a preferred mode of treatment for some. Outcomes other than relapse, as well as costs, should also be considered. Our findings that psychiatrists are associated with a decreased likelihood of relapse and that case management is associated with an increased likelihood of relapse despite a correlation with greater pharmacotherapy intensity present avenues for additional study." @default.
• W1505747863 created "2016-06-24" @default.
• W1505747863 creator A5012052314 @default.
• W1505747863 creator A5029455323 @default.
• W1505747863 creator A5050779662 @default.
• W1505747863 date "2002-12-01" @default.
• W1505747863 modified "2023-09-26" @default.
• W1505747863 title "Psychotherapy and Pharmacotherapy in Depression" @default.
• W1505747863 cites W1583862312 @default.
• W1505747863 cites W1584859660 @default.
• W1505747863 cites W1779963665 @default.
• W1505747863 cites W1962246885 @default.
• W1505747863 cites W1970661211 @default.
• W1505747863 cites W1973628995 @default.
• W1505747863 cites W2022287986 @default.
• W1505747863 cites W2042187859 @default.
• W1505747863 cites W2076829968 @default.
• W1505747863 cites W2092298947 @default.
• W1505747863 cites W2102246003 @default.
• W1505747863 cites W2109883993 @default.
• W1505747863 cites W2122264538 @default.
• W1505747863 cites W2138824525 @default.
• W1505747863 cites W2326556724 @default.
• W1505747863 cites W2399383621 @default.
• W1505747863 cites W3122822609 @default.
• W1505747863 cites W312995563 @default.
• W1505747863 hasPublicationYear "2002" @default.
• W1505747863 type Work @default.
• W1505747863 sameAs 1505747863 @default.
• W1505747863 citedByCount "2" @default.
• W1505747863 crossrefType "posted-content" @default.
• W1505747863 hasAuthorship W1505747863A5012052314 @default.
• W1505747863 hasAuthorship W1505747863A5029455323 @default.
• W1505747863 hasAuthorship W1505747863A5050779662 @default.
• W1505747863 hasConcept C118552586 @default.
• W1505747863 hasConcept C134362201 @default.
• W1505747863 hasConcept C139719470 @default.
• W1505747863 hasConcept C15744967 @default.
• W1505747863 hasConcept C162324750 @default.
• W1505747863 hasConcept C20387591 @default.
• W1505747863 hasConcept C2426938 @default.
• W1505747863 hasConcept C2776867660 @default.
• W1505747863 hasConcept C2779159551 @default.
• W1505747863 hasConcept C500440147 @default.
• W1505747863 hasConcept C70410870 @default.
• W1505747863 hasConcept C71924100 @default.
• W1505747863 hasConcept C98274493 @default.
• W1505747863 hasConceptScore W1505747863C118552586 @default.
• W1505747863 hasConceptScore W1505747863C134362201 @default.
• W1505747863 hasConceptScore W1505747863C139719470 @default.
• W1505747863 hasConceptScore W1505747863C15744967 @default.
• W1505747863 hasConceptScore W1505747863C162324750 @default.
• W1505747863 hasConceptScore W1505747863C20387591 @default.
• W1505747863 hasConceptScore W1505747863C2426938 @default.
• W1505747863 hasConceptScore W1505747863C2776867660 @default.
• W1505747863 hasConceptScore W1505747863C2779159551 @default.
• W1505747863 hasConceptScore W1505747863C500440147 @default.
• W1505747863 hasConceptScore W1505747863C70410870 @default.
• W1505747863 hasConceptScore W1505747863C71924100 @default.
• W1505747863 hasConceptScore W1505747863C98274493 @default.
• W1505747863 hasLocation W15057478631 @default.
• W1505747863 hasOpenAccess W1505747863 @default.
• W1505747863 hasPrimaryLocation W15057478631 @default.
• W1505747863 hasRelatedWork W1584859660 @default.
• W1505747863 hasRelatedWork W181499380 @default.
• W1505747863 hasRelatedWork W1971848649 @default.
• W1505747863 hasRelatedWork W1993372621 @default.
• W1505747863 hasRelatedWork W1996243346 @default.
• W1505747863 hasRelatedWork W1999871556 @default.
• W1505747863 hasRelatedWork W2010167850 @default.
• W1505747863 hasRelatedWork W2027248760 @default.
• W1505747863 hasRelatedWork W2053532176 @default.
• W1505747863 hasRelatedWork W2056142446 @default.
• W1505747863 hasRelatedWork W2062087273 @default.
• W1505747863 hasRelatedWork W2090333865 @default.
• W1505747863 hasRelatedWork W2093507687 @default.
• W1505747863 hasRelatedWork W2107183844 @default.
• W1505747863 hasRelatedWork W2109474313 @default.
• W1505747863 hasRelatedWork W2412809322 @default.
• W1505747863 hasRelatedWork W2474589390 @default.
• W1505747863 hasRelatedWork W2564615972 @default.
• W1505747863 hasRelatedWork W3122118338 @default.
• W1505747863 hasRelatedWork W3124143101 @default.
• W1505747863 isParatext "false" @default.
• W1505747863 isRetracted "false" @default.
• W1505747863 magId "1505747863" @default.
• W1505747863 workType "article" @default.