The effectiveness of Telepsychiatry-Based culturally sensitive collaborative treatment for depressed Chinese American immigrants

A randomized controlled trial

Albert Yeung, Max A. Martinson, Lee Baer, Justin Chen, Alisabet Clain, Aya Williams, Trina E. Chang, Nhi Ha T. Trinh, Jonathan E. Alpert, Maurizio Fava

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: This study evaluates the effectiveness of a telepsychiatry-based culturally sensitive collaborative treatment (T-CSCT) intervention to improve treatment outcomes for depressed Chinese American immigrants. Methods: Participants were Chinese Americans recruited from primary care settings from February 1, 2009, to July 31, 2012, with DSM-IV major depressive disorder (MDD) identified by the Mini-International Neuropsychiatric Interview. Eligible patients were randomized to receive either T-CSCT or treatment as usual (TAU) for 6 months. T-CSCT involves (1) cultural consultation via videoconference and (2) care management. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS17); positive response was defined as a ≥ 50% decrease in HDRS17 score, and remission was defined as HDRS17 score ≤ 7. Secondary outcome measures were the Clinical Global Impressions-Severity of Illness (CGI-S) and Improvement (CGI-I) scales and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Outcomes were compared using multivariate logistic regression and mixedmodel for repeated measures methods. Results: Among participants (N = 190), 63% were female, and the mean (SD) age was 50 (14.5) years. They were randomized to T-CSCT (n = 97; 51%) or TAU (n = 93; 49%). Using multivariate logistic regression analyses, the odds of achieving response and remission were significantly greater for the T-CSCT group compared to the control group (odds ratio [OR] = 3.9 [95% CI, 1.9 to 7.8] and 4.4 [95% CI, 1.9 to 9.9], respectively). Multivariate general linear model analyses showed that patients in the T-CSCT group had significantly greater improvement over time in HDRS17 (F4,95 = 4.59, P = .002), CGI-S (F4,95 = 4.22, P = .003), and CGI-I (F4,95 = 2.95, P = .02) scores. Conclusions: T-CSCT is effective in improving treatment outcomes of Chinese immigrants with MDD.

Original languageEnglish (US)
Pages (from-to)e996-e1002
JournalJournal of Clinical Psychiatry
Volume77
Issue number8
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

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Asian Americans
Randomized Controlled Trials
Therapeutics
Major Depressive Disorder
Logistic Models
Outcome Assessment (Health Care)
Videoconferencing
Diagnostic and Statistical Manual of Mental Disorders
Linear Models
Primary Health Care
Referral and Consultation
Odds Ratio
Regression Analysis
Quality of Life
Interviews
Depression
Control Groups

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

The effectiveness of Telepsychiatry-Based culturally sensitive collaborative treatment for depressed Chinese American immigrants : A randomized controlled trial. / Yeung, Albert; Martinson, Max A.; Baer, Lee; Chen, Justin; Clain, Alisabet; Williams, Aya; Chang, Trina E.; Trinh, Nhi Ha T.; Alpert, Jonathan E.; Fava, Maurizio.

In: Journal of Clinical Psychiatry, Vol. 77, No. 8, 01.08.2016, p. e996-e1002.

Research output: Contribution to journalArticle

Yeung, Albert ; Martinson, Max A. ; Baer, Lee ; Chen, Justin ; Clain, Alisabet ; Williams, Aya ; Chang, Trina E. ; Trinh, Nhi Ha T. ; Alpert, Jonathan E. ; Fava, Maurizio. / The effectiveness of Telepsychiatry-Based culturally sensitive collaborative treatment for depressed Chinese American immigrants : A randomized controlled trial. In: Journal of Clinical Psychiatry. 2016 ; Vol. 77, No. 8. pp. e996-e1002.
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title = "The effectiveness of Telepsychiatry-Based culturally sensitive collaborative treatment for depressed Chinese American immigrants: A randomized controlled trial",
abstract = "Objective: This study evaluates the effectiveness of a telepsychiatry-based culturally sensitive collaborative treatment (T-CSCT) intervention to improve treatment outcomes for depressed Chinese American immigrants. Methods: Participants were Chinese Americans recruited from primary care settings from February 1, 2009, to July 31, 2012, with DSM-IV major depressive disorder (MDD) identified by the Mini-International Neuropsychiatric Interview. Eligible patients were randomized to receive either T-CSCT or treatment as usual (TAU) for 6 months. T-CSCT involves (1) cultural consultation via videoconference and (2) care management. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS17); positive response was defined as a ≥ 50{\%} decrease in HDRS17 score, and remission was defined as HDRS17 score ≤ 7. Secondary outcome measures were the Clinical Global Impressions-Severity of Illness (CGI-S) and Improvement (CGI-I) scales and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Outcomes were compared using multivariate logistic regression and mixedmodel for repeated measures methods. Results: Among participants (N = 190), 63{\%} were female, and the mean (SD) age was 50 (14.5) years. They were randomized to T-CSCT (n = 97; 51{\%}) or TAU (n = 93; 49{\%}). Using multivariate logistic regression analyses, the odds of achieving response and remission were significantly greater for the T-CSCT group compared to the control group (odds ratio [OR] = 3.9 [95{\%} CI, 1.9 to 7.8] and 4.4 [95{\%} CI, 1.9 to 9.9], respectively). Multivariate general linear model analyses showed that patients in the T-CSCT group had significantly greater improvement over time in HDRS17 (F4,95 = 4.59, P = .002), CGI-S (F4,95 = 4.22, P = .003), and CGI-I (F4,95 = 2.95, P = .02) scores. Conclusions: T-CSCT is effective in improving treatment outcomes of Chinese immigrants with MDD.",
author = "Albert Yeung and Martinson, {Max A.} and Lee Baer and Justin Chen and Alisabet Clain and Aya Williams and Chang, {Trina E.} and Trinh, {Nhi Ha T.} and Alpert, {Jonathan E.} and Maurizio Fava",
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T2 - A randomized controlled trial

AU - Yeung, Albert

AU - Martinson, Max A.

AU - Baer, Lee

AU - Chen, Justin

AU - Clain, Alisabet

AU - Williams, Aya

AU - Chang, Trina E.

AU - Trinh, Nhi Ha T.

AU - Alpert, Jonathan E.

AU - Fava, Maurizio

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N2 - Objective: This study evaluates the effectiveness of a telepsychiatry-based culturally sensitive collaborative treatment (T-CSCT) intervention to improve treatment outcomes for depressed Chinese American immigrants. Methods: Participants were Chinese Americans recruited from primary care settings from February 1, 2009, to July 31, 2012, with DSM-IV major depressive disorder (MDD) identified by the Mini-International Neuropsychiatric Interview. Eligible patients were randomized to receive either T-CSCT or treatment as usual (TAU) for 6 months. T-CSCT involves (1) cultural consultation via videoconference and (2) care management. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS17); positive response was defined as a ≥ 50% decrease in HDRS17 score, and remission was defined as HDRS17 score ≤ 7. Secondary outcome measures were the Clinical Global Impressions-Severity of Illness (CGI-S) and Improvement (CGI-I) scales and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Outcomes were compared using multivariate logistic regression and mixedmodel for repeated measures methods. Results: Among participants (N = 190), 63% were female, and the mean (SD) age was 50 (14.5) years. They were randomized to T-CSCT (n = 97; 51%) or TAU (n = 93; 49%). Using multivariate logistic regression analyses, the odds of achieving response and remission were significantly greater for the T-CSCT group compared to the control group (odds ratio [OR] = 3.9 [95% CI, 1.9 to 7.8] and 4.4 [95% CI, 1.9 to 9.9], respectively). Multivariate general linear model analyses showed that patients in the T-CSCT group had significantly greater improvement over time in HDRS17 (F4,95 = 4.59, P = .002), CGI-S (F4,95 = 4.22, P = .003), and CGI-I (F4,95 = 2.95, P = .02) scores. Conclusions: T-CSCT is effective in improving treatment outcomes of Chinese immigrants with MDD.

AB - Objective: This study evaluates the effectiveness of a telepsychiatry-based culturally sensitive collaborative treatment (T-CSCT) intervention to improve treatment outcomes for depressed Chinese American immigrants. Methods: Participants were Chinese Americans recruited from primary care settings from February 1, 2009, to July 31, 2012, with DSM-IV major depressive disorder (MDD) identified by the Mini-International Neuropsychiatric Interview. Eligible patients were randomized to receive either T-CSCT or treatment as usual (TAU) for 6 months. T-CSCT involves (1) cultural consultation via videoconference and (2) care management. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS17); positive response was defined as a ≥ 50% decrease in HDRS17 score, and remission was defined as HDRS17 score ≤ 7. Secondary outcome measures were the Clinical Global Impressions-Severity of Illness (CGI-S) and Improvement (CGI-I) scales and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Outcomes were compared using multivariate logistic regression and mixedmodel for repeated measures methods. Results: Among participants (N = 190), 63% were female, and the mean (SD) age was 50 (14.5) years. They were randomized to T-CSCT (n = 97; 51%) or TAU (n = 93; 49%). Using multivariate logistic regression analyses, the odds of achieving response and remission were significantly greater for the T-CSCT group compared to the control group (odds ratio [OR] = 3.9 [95% CI, 1.9 to 7.8] and 4.4 [95% CI, 1.9 to 9.9], respectively). Multivariate general linear model analyses showed that patients in the T-CSCT group had significantly greater improvement over time in HDRS17 (F4,95 = 4.59, P = .002), CGI-S (F4,95 = 4.22, P = .003), and CGI-I (F4,95 = 2.95, P = .02) scores. Conclusions: T-CSCT is effective in improving treatment outcomes of Chinese immigrants with MDD.

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