Depressive symptom reversal for women in a primary care setting: a pilot study

Cognizant that only 20% of depressed individuals seek treatment, Healthy People 2000 has recommended a goal of increasing this figure to 45%. This flows from a recognition of depression as a serious and costly problem, with women carrying twice the risk of men. Primary care settings are the first contact a depressed woman may make with the health care system. This study piloted a collaborative model in which a Psychiatric Mental Health Advanced Practice Nurse (PMH-APN) was available on site to assist providers to recognize women with depressive symptoms and to provide intervention. Thirty three women were identified by primary care providers and referred for screening to the PMH-APN. Assessment and intervention based on the interpersonal theory of Peplau were accomplished in an average of eight sessions with the PMH-APN. Pre and postintervention descriptive data on the primary outcome (depressive symptoms) and three theoretically congruent mediating variables (performance and social self-esteem and satisfaction with interpersonal relations) were consistent with the expected outcomes of the intervention.