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Depression Treatment for Co-Morbidities: A Gateway for Assessment

Explore the link between depression treatment and co-occurring disorders, such as bipolar, PTSD, and anxiety, with key insights on treatment seeking behaviors and limitations in mental health services. Gain valuable information on effective screening and diagnosis for comprehensive care programs.

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Depression Treatment for Co-Morbidities: A Gateway for Assessment

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  1. Treatment for Depression as a Gateway for Assessment and Treatment of Other Co-Morbidities Jose M. Pena , MD Randal M. Graf, PhD M. Scott Tims, MS

  2. “I have no actual or potential conflict of interest in relation to this educational activity or presentation”

  3. Surveys • American College Health Association - National College Health Assessment (ACHA) • National Survey of Counseling Center Directors (Gallagher, RP) • Mental Health Care in the College Community, (ed. Kay J and Schwartz V) • College Student Mental Health : Effective Services and Strategies Across Campus (ed. Benton A and Benton L)

  4. Increase in Number and Severity of Mental Health Problems • Anxiety 13% • Anorexia 2% • Bulimia 2% • Depression 18% • Considered Suicide (1yr.) 9 % • Attempted Suicide (Life) 1% • On Psych Medication 36% ACHA, 2008; Kay 2010

  5. Increased Need for Services • Directors of Health Services • 93% report increase in # of students on meds. • 95% report greater acuity • Staff burnout • Service shortages during peak times • 67% report increase in crisis counseling • 60% increased demand w/o increased resources Gallagher 2008

  6. On-Line Mental Health Self-Assessment Survey • Demographic Information • Six Domains • Depression (DEP, n=230) • Bipolar (BP, n=88) • Alcohol Use (AU, n=32) • Eating Dis. (ED, n=58) • Generalized Anxiety (GAD, n=102) • Posttraumatic Stress (PTSD, n=26) • Likelihood of problem • Received Treatment

  7. Demographic Information Across All Groups • Caucasian (62-77%) • Female (74-91%) • Undergraduates (59-75%)

  8. Within Group: Very likely to have the identified problem • Depression (89%) • Bipolar Dis. (34%) • Alcohol Use (91%) • Eating Dis. (66%) • Generalized Anxiety Dis. ( 96%) • PTSD (100%)

  9. Within Group Treatment Seeking (vs. Likelihood) • Depression 27% (vs. 89%) • Bipolar Disorder 2% (vs. 34%) • Alcohol Use 3% (vs. 91%) • Eating Dis. 19% (vs. 66%) • Generalized Anxiety 19% (vs. 96%) • PTSD 12% (vs. 100%) • Low utilization Across Groups

  10. Within Group Treatment Seeking for Depression > Other • Bipolar Dis. P< .0001 • Alcohol Use P< .0027 • Eating Dis. P< .0086 • PTSD P< .0522 • Generalized Anxiety P< .2407 • Treatment seeking for depression much more likely than for other problems, with trends in same direction

  11. Limitations • Demographic : predominantly Caucasian, Female, undergrad. • Self-selection • Small sample size

  12. Discussion • All groups: Low treatment utilization • Treated Depression highest at only 27% • Increased Demand vs. Resources • ?? Tip of the Iceberg

  13. Treatment Seeking for Depression • Co-Morbidity • Bipolar Dis. • Alcohol Use • PTSD • ED • GAD

  14. Treatment Seeking • Recall: PTSD • Disclosure : PTSD, ED, Alcohol (SA) • Denial: Alcohol (SA), ED, Bipolar • Distress • Bipolar I : 32% Dep : 15% Mania/Cycling • Bipolar II : 50% Dep; 4% Hypo/Cycling • Age/Onset: DSM/Bipolar? • Stigma: GAD weakest trend Judd LL et al ArchGenPsych 2002

  15. Importance of Effective Screening and Diagnosis • Subjective Chief complaint vs. Co-Morbidity • Mental health and Non-mental health settings • Anti-depressant Rx • PHQ

  16. Recommendations Prevention/Screening Clinical Care/Programs Randall M. Graf, PhD • M. Scott Tims, MS

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