Collaborative Care for Women With Depression: A Systematic Review.

BACKGROUND

The collaborative care model has been found to be effective for depression management in various primary care populations; however, no review has synthesized trials tailored to treat women.

OBJECTIVE

The purpose of this systematic review is to evaluate the current evidence for collaborative depression care for women.

METHODOLOGY

We searched for English language articles via MEDLINE, CINAHL, PsycINFO, EMBASE, Cochrane Library, and reference lists of key articles. Published English language studies were included if they described collaborative care models that targeted women, regardless of study design. Studies were excluded if components of collaborative care were absent (based on criteria described by the Advancing Integrated Mental Health Solutions Center at the University of Washington), if the focus of the intervention was not women, if the studies were not conducted in primary care or gynecological settings, or if there were no outcome data.

RESULTS

This review resulted in 7 articles that met the inclusion criteria. Included studies were 6 randomized controlled trials and 1 observational study. Among those, 4 studies focused on pregnant or postpartum women. In general, collaborative care interventions focusing on women were more effective than usual care for the management of depressive disorders in women with 5 of the 6 randomized studies showing positive depression outcomes.

CONCLUSIONS

There is evidence that collaborative care interventions are effective for treating depressed women in nonmental health settings. Future studies should examine differences in implementation of collaborative care in "real world" settings and define modifications needed based on a woman's reproductive life stage.