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CDA 07-206 – HSR Study

 
CDA 07-206
VA Depression Treatments: Practice, Policy and Cost-Effectiveness
Kara Zivin, PhD MS MA
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, MI
Funding Period: January 2009 - December 2013
BACKGROUND/RATIONALE:
Although the VA treats a substantial number of cases of depression annually, there is no existing model that captures how the VA provides depression care. Understanding depression care can help improve patient care and outcomes. This research aims to quantify and simulate the long-term costs and benefits of VA depression care, to examine variation in care across VA's, and identify how this affects cost-effectiveness of depression care.

OBJECTIVE(S):
This project developed methods to evaluate targeted, patient-centered and system-level interventions aimed at improving VA depression care. The study utilized a conceptual model to incorporate three main goals: 1) to develop a usual care base case model incorporating factors affecting variation in usual care for depression among VA patients, including patient, provider, and system level factors; 2) to evaluate current treatment models and therapies of depression care, as well as looking at effectiveness of care, costs of care and interventions, and cost-effectiveness models of usual care and variations of current treatment; and 3) to examine future policy and program change including evaluation of targeted interventions and developing thresholds and comparisons for future interventions.

METHODS:
This project combined data from several sources of VA adminsitrative and survey data to create a VA-specific depression practice and policy model, as well as published literature. We will create a detailed, longitudinal Markov model using VA services and cost data, mortality data from the National Death Index (NDI), quality-adjusted life years (QALYs) and simulated information on outcomes of depression treatment in the VA.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
For VA Central Office and clinicians, understanding current depression care patterns, outcomes, and costs is essential to improving patient care and health. Our findings that antidepressants, while being cheaper and more typically used in the VA, are not as cost effective as psychotherapy for the treatment of depression, have the potential to influence future VA practice and policy. Dr. David Atkins, HSR&D Director, expressed his interest in these findings when I presented them at the VA CDA meeting earlier this year (2014).

External Links for this Project

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PUBLICATIONS:

Journal Articles

  1. Zivin K, Pfeiffer PN, McCammon RJ, Kavanagh JS, Walters H, Welsh DE, Difranco DJ, Brown MM, Valenstein M. "No-shows": who fails to follow up with initial behavioral health treatment? The American journal of managed care. 2009 Feb 1; 15(2):105-12. [view]
  2. McCarthy JF, Valenstein M, Zivin K, Zeber JE, Kilbourne AM. Access-related measures and out-of-system utilization among veterans with bipolar disorder. Psychiatric services (Washington, D.C.). 2010 Oct 1; 61(10):1035-8. [view]
  3. Zivin K, Ganoczy D, Pfeiffer PN, Miller EM, Valenstein M. Antidepressant adherence after psychiatric hospitalization among VA patients with depression. Administration and policy in mental health. 2009 Nov 1; 36(6):406-15. [view]
  4. Valenstein M, Kim HM, Ganoczy D, Eisenberg D, Pfeiffer PN, Downing K, Hoggatt K, Ilgen M, Austin KL, Zivin K, Blow FC, McCarthy JF. Antidepressant agents and suicide death among US Department of Veterans Affairs patients in depression treatment. Journal of Clinical Psychopharmacology. 2012 Jun 1; 32(3):346-53. [view]
  5. Zivin K. Antidepressant non-adherence is common among veterans, with ineffectiveness and side effects as commonly reported reasons. Evidence-Based Mental Health. 2011 Nov 1; 14(4):91. [view]
  6. Saczynski JS, Rosen AB, McCammon RJ, Zivin K, Andrade SE, Langa KM, Vijan S, Pirraglia PA, Briesacher BA. Antidepressant Use and Cognitive Decline: The Health and Retirement Study. The American journal of medicine. 2015 Jul 1; 128(7):739-46. [view]
  7. Pfeiffer PN, Szymanski BR, Zivin K, Post EP, Valenstein M, McCarthy JF. Are primary care mental health services associated with differences in specialty mental health clinic use? Psychiatric services (Washington, D.C.). 2011 Apr 1; 62(4):422-5. [view]
  8. Gibbons JB, McCullough JS, Zivin K, Brown ZY, Norton EC. Association Between Buprenorphine Treatment Gaps, Opioid Overdose, and Health Care Spending in US Medicare Beneficiaries With Opioid Use Disorder. JAMA psychiatry. 2022 Dec 1; 79(12):1173-1179. [view]
  9. Tipirneni R, Patel MR, Goold SD, Kieffer EC, Ayanian JZ, Clark SJ, Lee S, Bryant C, Kirch MA, Solway E, Luster J, Lewallen M, Zivin K. Association of Expanded Medicaid Coverage With Health and Job-Related Outcomes Among Enrollees With Behavioral Health Disorders. Psychiatric services (Washington, D.C.). 2020 Jan 1; 71(1):4-11. [view]
  10. Zivin K, Yosef M, Miller EM, Valenstein M, Duffy S, Kales HC, Vijan S, Kim HM. Associations between depression and all-cause and cause-specific risk of death: a retrospective cohort study in the Veterans Health Administration. Journal of psychosomatic research. 2015 Apr 1; 78(4):324-31. [view]
  11. Pfeiffer PN, Ganoczy D, Zivin K, Valenstein M. Benzodiazepines and adequacy of initial antidepressant treatment for depression. Journal of Clinical Psychopharmacology. 2011 Jun 1; 31(3):360-4. [view]
  12. Tipirneni R, Levy HG, Langa KM, McCammon RJ, Zivin K, Luster J, Karmakar M, Ayanian JZ. Changes in Health Care Access and Utilization for Low-SES Adults Aged 51-64 Years After Medicaid Expansion. The journals of gerontology. Series B, Psychological sciences and social sciences. 2021 Jun 14; 76(6):1218-1230. [view]
  13. Burnett-Zeigler I, Valenstein M, Ilgen M, Blow AJ, Gorman LA, Zivin K. Civilian employment among recently returning Afghanistan and Iraq National Guard veterans. Military medicine. 2011 Jun 1; 176(6):639-46. [view]
  14. Pfeiffer PN, Ganoczy D, Ilgen M, Zivin K, Valenstein M. Comorbid anxiety as a suicide risk factor among depressed veterans. Depression and anxiety. 2009 Jan 1; 26(8):752-7. [view]
  15. Flynn HA, Sexton M, Ratliff S, Porter K, Zivin K. Comparative performance of the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire-9 in pregnant and postpartum women seeking psychiatric services. Psychiatry Research. 2011 May 15; 187(1-2):130-4. [view]
  16. Hwang S, Jayadevappa R, Zee J, Zivin K, Bogner HR, Raue PJ, Bruce ML, Reynolds CF, Gallo JJ. Concordance Between Clinical Diagnosis and Medicare Claims of Depression Among Older Primary Care Patients. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2015 Jul 1; 23(7):726-34. [view]
  17. Ross EL, Zivin K, Maixner DF. Cost-effectiveness of Electroconvulsive Therapy vs Pharmacotherapy/Psychotherapy for Treatment-Resistant Depression in the United States. JAMA psychiatry. 2018 Jul 1; 75(7):713-722. [view]
  18. Zivin K, Madden JM, Graves AJ, Zhang F, Soumerai SB. Cost-related medication nonadherence among beneficiaries with depression following Medicare Part D. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2009 Dec 1; 17(12):1068-76. [view]
  19. Zivin K, Llewellyn DJ, Lang IA, Vijan S, Kabeto MU, Miller EM, Langa KM. Depression among older adults in the United States and England. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2010 Nov 1; 18(11):1036-44. [view]
  20. Davydow DS, Hough CL, Zivin K, Langa KM, Katon WJ. Depression and risk of hospitalization for pneumonia in a cohort study of older Americans. Journal of psychosomatic research. 2014 Dec 1; 77(6):528-34. [view]
  21. Burnett-Zeigler I, Zivin K, Ilgen M, Szymanski B, Blow FC, Kales HC. Depression treatment in older adult veterans. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2012 Mar 1; 20(3):228-38. [view]
  22. Bergmans RS, Zivin K, Mezuk B. Depression, food insecurity and diabetic morbidity: Evidence from the Health and Retirement Study. Journal of psychosomatic research. 2019 Feb 1; 117:22-29. [view]
  23. Zivin K, Allen L, Barnes AJ, Junker S, Kim JY, Tang L, Kennedy S, Ahrens KA, Burns M, Clark S, Cole E, Crane D, Idala D, Lanier P, Mohamoud S, Jarlenski M, McDuffie MJ, Talbert J, Gordon AJ, Donohue JM. Design, Implementation, and Evolution of the Medicaid Outcomes Distributed Research Network (MODRN). Medical care. 2022 Sep 1; 60(9):680-690. [view]
  24. Aikens JE, Zivin K, Trivedi R, Piette JD. Diabetes self-management support using mHealth and enhanced informal caregiving. Journal of diabetes and its complications. 2014 Mar 1; 28(2):171-6. [view]
  25. Levine DS, Valenstein M, Yosef M, Mavandadi S, Oslin DW, Himle JA, Zivin K. Differences in Mental Health Service Use Among Unemployed Veterans of Different Eras. The Journal of nervous and mental disease. 2018 Feb 1; 206(2):155-158. [view]
  26. Zivin K, Ilgen MA, Pfeiffer PN, Welsh DE, McCarthy J, Valenstein M, Miller EM, Islam K, Kales HC. Early mortality and years of potential life lost among Veterans Affairs patients with depression. Psychiatric services (Washington, D.C.). 2012 Aug 1; 63(8):823-6. [view]
  27. Zivin K, Paczkowski M, Galea S. Economic downturns and population mental health: research findings, gaps, challenges and priorities. Psychological medicine. 2011 Jul 1; 41(7):1343-8. [view]
  28. Zivin K, Kerber K, Kuebler J, Jiang Q, Walters H, Klinkman M, McInnis M, Valenstein M. Effectiveness of a depression disease management program in improving depression and work function--a pilot study. International journal of psychiatry in medicine. 2009 Jan 1; 39(1):1-13. [view]
  29. Pfeiffer PN, Pope B, Houck M, Benn-Burton W, Zivin K, Ganoczy D, Kim HM, Walters H, Emerson L, Nelson CB, Abraham KM, Valenstein M. Effectiveness of Peer-Supported Computer-Based CBT for Depression Among Veterans in Primary Care. Psychiatric services (Washington, D.C.). 2020 Mar 1; 71(3):256-262. [view]
  30. Pfeiffer PN, Valenstein M, Hoggatt KJ, Ganoczy D, Maixner D, Miller EM, Zivin K. Electroconvulsive therapy for major depression within the Veterans Health Administration. Journal of affective disorders. 2011 Apr 1; 130(1-2):21-5. [view]
  31. Zivin K, Bohnert AS, Mezuk B, Ilgen MA, Welsh D, Ratliff S, Miller EM, Valenstein M, Kilbourne AM. Employment status of patients in the VA health system: implications for mental health services. Psychiatric services (Washington, D.C.). 2011 Jan 1; 62(1):35-8. [view]
  32. Zivin K, Pfeiffer PN, Bohnert AS, Ganoczy D, Blow FC, Nallamothu BK, Kales HC. Evaluation of the FDA warning against prescribing citalopram at doses exceeding 40 mg. The American journal of psychiatry. 2013 Jun 1; 170(6):642-50. [view]
  33. Zivin K, Ratliff S, Heisler MM, Langa KM, Piette JD. Factors Influencing Cost-Related Nonadherence to Medication in Older Adults: A Conceptually Based Approach. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2010 Jun 1. [view]
  34. Bolkan CR, Bonner LM, Campbell DG, Lanto A, Zivin K, Chaney E, Rubenstein LV. Family involvement, medication adherence, and depression outcomes among patients in veterans affairs primary care. Psychiatric services (Washington, D.C.). 2013 May 1; 64(5):472-8. [view]
  35. Luca DL, Margiotta C, Staatz C, Garlow E, Christensen A, Zivin K. Financial Toll of Untreated Perinatal Mood and Anxiety Disorders Among 2017 Births in the United States. American journal of public health. 2020 Jun 1; 110(6):888-896. [view]
  36. Bergmans RS, Mezuk B, Zivin K. Food Insecurity and Geriatric Hospitalization. International journal of environmental research and public health. 2019 Jun 28; 16(13). [view]
  37. Bonner LM, Lanto AB, Bolkan C, Watson GS, Campbell DG, Chaney EF, Zivin K, Rubenstein LV. Help-seeking from clergy and spiritual counselors among veterans with depression and PTSD in primary care. Journal of Religion and Health. 2013 Sep 1; 52(3):707-18. [view]
  38. Valenstein M, Kim HM, Ganoczy D, McCarthy JF, Zivin K, Austin KL, Hoggatt K, Eisenberg D, Piette JD, Blow FC, Olfson M. Higher-risk periods for suicide among VA patients receiving depression treatment: prioritizing suicide prevention efforts. Journal of affective disorders. 2009 Jan 1; 112(1-3):50-8. [view]
  39. Zivin K, Pfeiffer PN, Szymanski BR, Valenstein M, Post EP, Miller EM, McCarthy JF. Initiation of Primary Care-Mental Health Integration programs in the VA Health System: associations with psychiatric diagnoses in primary care. Medical care. 2010 Sep 1; 48(9):843-51. [view]
  40. Adams L, Kennedy S, Allen L, Barnes A, Bias T, Crane D, Lanier P, Mauk R, Mohamoud S, Pauly N, Talbert J, Woodcock C, Zivin K, Donohue J. Innovative Solutions for State Medicaid Programs to Leverage Their Data, Build Their Analytic Capacity, and Create Evidence-Based Policy. EGEMS (Washington, DC). 2019 Aug 5; 7(1):41. [view]
  41. Pfeiffer PN, Szymanski B, Dhawan N, Difranco D, Valenstein M, Zivin K. Is there an "unhealthy volunteer effect" in mental health outpatient research? Psychiatry Research. 2010 Apr 30; 176(2-3):224-8. [view]
  42. Mezuk B, Bohnert AS, Ratliff S, Zivin K. Job strain, depressive symptoms, and drinking behavior among older adults: results from the health and retirement study. The journals of gerontology. Series B, Psychological sciences and social sciences. 2011 Jul 1; 66(4):426-34. [view]
  43. Ilgen MA, Price AM, Burnett-Zeigler I, Perron B, Islam K, Bohnert AS, Zivin K. Longitudinal predictors of addictions treatment utilization in treatment-naïve adults with alcohol use disorders. Drug and Alcohol Dependence. 2011 Jan 15; 113(2-3):215-21. [view]
  44. Burnett-Zeigler I, Zivin K, Islam K, Ilgen MA. Longitudinal predictors of first time depression treatment utilization among adults with depressive disorders. Social psychiatry and psychiatric epidemiology. 2012 Oct 1; 47(10):1617-25. [view]
  45. Eisenberg D, Hunt J, Speer N, Zivin K. Mental health service utilization among college students in the United States. The Journal of nervous and mental disease. 2011 May 1; 199(5):301-8. [view]
  46. Tam J, Taylor GMJ, Zivin K, Warner KE, Meza R. Modeling smoking-attributable mortality among adults with major depression in the United States. Preventive medicine. 2020 Nov 1; 140:106241. [view]
  47. Davydow DS, Zivin K, Katon WJ, Pontone GM, Chwastiak L, Langa KM, Iwashyna TJ. Neuropsychiatric disorders and potentially preventable hospitalizations in a prospective cohort study of older Americans. Journal of general internal medicine. 2014 Oct 1; 29(10):1362-71. [view]
  48. Peahl AF, Morgan DM, Dalton VK, Zivin K, Lai YL, Hu HM, Langen E, Low LK, Brummett CM, Waljee JF, Bauer ME. New persistent opioid use after acute opioid prescribing in pregnancy: a nationwide analysis. American journal of obstetrics and gynecology. 2020 Oct 1; 223(4):566.e1-566.e13. [view]
  49. Bergmans RS, Zivin K, Mezuk B. Perceived sleep quality, coping behavior, and associations with major depression among older adults. Journal of Health Psychology. 2021 Sep 1; 26(11):1913-1925. [view]
  50. Burnett-Zeigler I, Zivin K, Ilgen MA, Islam K, Bohnert AS. Perceptions of quality of health care among veterans with psychiatric disorders. Psychiatric services (Washington, D.C.). 2011 Sep 1; 62(9):1054-9. [view]
  51. Kim HM, Zivin K, Choe HM, Stano CM, Ganoczy D, Walters H, Valenstein M. Predictors of start of different antidepressants in patient charts among patients with depression. Journal of managed care & specialty pharmacy. 2015 May 1; 21(5):424-30. [view]
  52. Grekin R, Zivin K, Hall SV, Van T, Mattocks KM. Predictors of Veterans Affairs Health Service Utilization by Women Veterans during Pregnancy. Women's health issues : official publication of the Jacobs Institute of Women's Health. 2020 Jul 1; 30(4):292-298. [view]
  53. Haffajee RL, Faherty LJ, Zivin K. Pregnant Women with Substance Use Disorders - The Harm Associated with Punitive Approaches. The New England journal of medicine. 2021 Jun 24; 384(25):2364-2367. [view]
  54. Burnett-Zeigler I, Ilgen M, Valenstein M, Zivin K, Gorman L, Blow A, Duffy S, Chermack S. Prevalence and correlates of alcohol misuse among returning Afghanistan and Iraq veterans. Addictive Behaviors. 2011 Aug 1; 36(8):801-6. [view]
  55. Glass JE, Perron BE, Ilgen MA, Chermack ST, Ratliff S, Zivin K. Prevalence and correlates of specialty substance use disorder treatment for Department of Veterans Affairs Healthcare System patients with high alcohol consumption. Drug and Alcohol Dependence. 2010 Nov 1; 112(1-2):150-5. [view]
  56. Maust DT, Strominger J, Bynum JPW, Langa KM, Gerlach LB, Zivin K, Marcus SC. Prevalence of Psychotropic and Opioid Prescription Fills Among Community-Dwelling Older Adults With Dementia in the US. JAMA. 2020 Aug 18; 324(7):706-708. [view]
  57. Johnson-Lawrence VD, Szymanski BR, Zivin K, McCarthy JF, Valenstein M, Pfeiffer PN. Primary care-mental health integration programs in the veterans affairs health system serve a different patient population than specialty mental health clinics. The primary care companion for CNS disorders. 2012 May 17; 14(3). [view]
  58. Burnett-Zeigler IE, Pfeiffer P, Zivin K, Glass JE, Ilgen MA, Flynn HA, Austin K, Chermack ST. Psychotherapy utilization for acute depression within the Veterans Affairs health care system. Psychological Services. 2012 Nov 1; 9(4):325-35. [view]
  59. Daw JR, Kolenic GE, Dalton VK, Zivin K, Winkelman T, Kozhimannil KB, Admon LK. Racial and Ethnic Disparities in Perinatal Insurance Coverage. Obstetrics and gynecology. 2020 Apr 1; 135(4):917-924. [view]
  60. Bohnert AS, Zivin K, Welsh DE, Kilbourne AM. Ratings of patient-provider communication among veterans: serious mental illnesses, substance use disorders, and the moderating role of trust. Health communication. 2011 Apr 1; 26(3):267-74. [view]
  61. Abraham KM, Ganoczy D, Yosef M, Resnick SG, Zivin K. Receipt of employment services among Veterans Health Administration users with psychiatric diagnoses. Journal of rehabilitation research and development. 2014 Jun 1; 51(3):401-14. [view]
  62. Zivin K, Brower KJ, Sen S, Brownlee RM, Gold KJ. Relationship Between Faculty Characteristics and Emotional Exhaustion in a Large Academic Medical Center. Journal of occupational and environmental medicine. 2020 Aug 1; 62(8):611-617. [view]
  63. Zivin K, Campbell DG, Lanto AB, Chaney EF, Bolkan C, Bonner LM, Miller EM, Valenstein M, Waltz TJ, Rubenstein LV. Relationships between mood and employment over time among depressed VA primary care patients. General hospital psychiatry. 2012 Sep 1; 34(5):468-77. [view]
  64. Valenstein M, Eisenberg D, McCarthy JF, Austin KL, Ganoczy D, Kim HM, Zivin K, Piette JD, Olfson M, Blow FC. Service implications of providing intensive monitoring during high-risk periods for suicide among VA patients with depression. Psychiatric services (Washington, D.C.). 2009 Apr 1; 60(4):439-44. [view]
  65. Ilgen MA, Zivin K, Austin KL, Bohnert AS, Czyz EK, Valenstein M, Kilbourne AM. Severe pain predicts greater likelihood of subsequent suicide. Suicide & Life-Threatening Behavior. 2010 Dec 1; 40(6):597-608. [view]
  66. Erickson SR, Guthrie S, Vanetten-Lee M, Himle J, Hoffman J, Santos SF, Janeck AS, Zivin K, Abelson JL. Severity of anxiety and work-related outcomes of patients with anxiety disorders. Depression and anxiety. 2009 Jan 1; 26(12):1165-71. [view]
  67. Eisenberg D, Downs MF, Golberstein E, Zivin K. Stigma and help seeking for mental health among college students. Medical care research and review : MCRR. 2009 Oct 1; 66(5):522-41. [view]
  68. Johnson JG, First MB, Block S, Vanderwerker LC, Zivin K, Zhang B, Prigerson HG. Stigmatization and receptivity to mental health services among recently bereaved adults. Death Studies. 2009 Sep 1; 33(8):691-711. [view]
  69. Jarlenski M, Krans EE, Chen Q, Rothenberger SD, Cartus A, Zivin K, Bodnar LM. Substance use disorders and risk of severe maternal morbidity in the United States. Drug and Alcohol Dependence. 2020 Nov 1; 216:108236. [view]
  70. Burnett-Zeigler I, Kim HM, Chiang C, Kavanagh J, Zivin K, Rockefeller K, Sirey JA, Kales HC. The association between race and gender, treatment attitudes, and antidepressant treatment adherence. International journal of geriatric psychiatry. 2014 Feb 1; 29(2):169-77. [view]
  71. Davydow DS, Levine DA, Zivin K, Katon WJ, Langa KM. The association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: a cohort study. Psychosomatic medicine. 2015 Feb 1; 77(2):200-8. [view]
  72. Rosen T, Zivin K, Eisenberg D, Guille C, Sen S. The Cost of Depression-Related Presenteeism in Resident Physicians. Academic Psychiatry : The Journal of The American Association of Directors of Psychiatric Residency Training and The Association For Academic Psychiatry. 2018 Feb 1; 42(1):84-87. [view]
  73. Ross EL, Vijan S, Miller EM, Valenstein M, Zivin K. The Cost-Effectiveness of Cognitive Behavioral Therapy Versus Second-Generation Antidepressants for Initial Treatment of Major Depressive Disorder in the United States: A Decision Analytic Model. Annals of internal medicine. 2019 Dec 3; 171(11):785-795. [view]
  74. Margiotta C, Gao J, O'Neil S, Vohra D, Zivin K. The economic impact of untreated maternal mental health conditions in Texas. BMC pregnancy and childbirth. 2022 Sep 12; 22(1):700. [view]
  75. Zivin K, Kabeto MU, Kales HC, Langa KM. The effect of depression and cognitive impairment on enrollment in Medicare Part D. Journal of the American Geriatrics Society. 2009 Aug 1; 57(8):1433-40. [view]
  76. Burnett-Zeigler I, Ilgen MA, Bohnert K, Miller E, Islam K, Zivin K. The impact of psychiatric disorders on employment: results from a national survey (NESARC). Community mental health journal. 2013 Jun 1; 49(3):303-10. [view]
  77. Tracy M, Morgenstern H, Zivin K, Aiello AE, Galea S. Traumatic event exposure and depression severity over time: results from a prospective cohort study in an urban area. Social psychiatry and psychiatric epidemiology. 2014 Nov 1; 49(11):1769-82. [view]
  78. Pfeiffer PN, Kim HM, Ganoczy D, Zivin K, Valenstein M. Treatment-resistant depression and risk of suicide. Suicide & Life-Threatening Behavior. 2013 Aug 1; 43(4):356-65. [view]
  79. Tabb KM, Dalton VK, Tilea A, Kolenic GE, Admon LK, Hall SV, Zhang X, Ryckman KK, Zivin K. Trends in antenatal depression and suicidal ideation diagnoses among commercially insured childbearing individuals in the United States, 2008-2018. Journal of affective disorders. 2023 Jan 1; 320:263-267. [view]
  80. Pfeiffer PN, Szymanski BR, Valenstein M, McCarthy JF, Zivin K. Trends in antidepressant prescribing for new episodes of depression and implications for health system quality measures. Medical care. 2012 Jan 1; 50(1):86-90. [view]
  81. Kales HC, Zivin K, Kim HM, Valenstein M, Chiang C, Ignacio RV, Ganoczy D, Cunningham F, Schneider LS, Blow FC. Trends in antipsychotic use in dementia 1999-2007. Archives of general psychiatry. 2011 Feb 1; 68(2):190-7. [view]
  82. Zivin K, Pirraglia PA, McCammon RJ, Langa KM, Vijan S. Trends in depressive symptom burden among older adults in the United States from 1998 to 2008. Journal of general internal medicine. 2013 Dec 1; 28(12):1611-9. [view]
  83. Tam J, Mezuk B, Zivin K, Meza R. U.S. Simulation of Lifetime Major Depressive Episode Prevalence and Recall Error. American journal of preventive medicine. 2020 Aug 1; 59(2):e39-e47. [view]
  84. Johnson-Lawrence V, Zivin K, Szymanski BR, Pfeiffer PN, McCarthy JF. VA primary care-mental health integration: patient characteristics and receipt of mental health services, 2008-2010. Psychiatric services (Washington, D.C.). 2012 Nov 1; 63(11):1137-41. [view]
  85. Kim HM, Smith EG, Stano CM, Ganoczy D, Zivin K, Walters H, Valenstein M. Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use. BMC health services research. 2012 Jan 23; 12(1):18. [view]
  86. Waltz TJ, Campbell DG, Kirchner JE, Lombardero A, Bolkan C, Zivin K, Lanto AB, Chaney EF, Rubenstein LV. Veterans with depression in primary care: provider preferences, matching, and care satisfaction. Families, systems & health : the journal of collaborative family healthcare. 2014 Dec 1; 32(4):367-77. [view]
  87. Burgard SA, Elliott MR, Zivin K, House JS. Working conditions and depressive symptoms: a prospective study of US adults. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. 2013 Sep 1; 55(9):1007-14. [view]
Journal Other

  1. Maust DT, Zivin K. Do organizations forming ACOs have mental health providers? [Letter to the Editor]. Psychiatric services (Washington, D.C.). 2014 Oct 1; 65(10):1286-7. [view]
  2. Zivin K, Katon W. Further policy changes are needed to improve depression care. [Letter to the Editor]. General hospital psychiatry. 2015 Jul 1; 37(4):368-9. [view]
  3. Zivin K. How are prescribing decisions made? [Editorial]. Psychiatric services (Washington, D.C.). 2013 Apr 1; 64(4):295. [view]
  4. Zivin K, Pfeiffer PN, Bohnert AS, Ganoczy D, Blow FC, Nallamothu BK, Kales HC. Safety of high-dosage citalopram. The American journal of psychiatry. 2014 Jan 1; 171(1):20-2. [view]
Magazine/Popular Press Articles

  1. Zivin K. VA Researchers Question FDA Antidepressant Warning. Psychiatric News. 2013 Jun 5. [view]
Conference Presentations

  1. McCammon RJ, Zivin K, Llewellyn DJ, Lang IA, Jones RN, Langa KM. An Assessment of the cross-national equivalence of a depressive symptoms scale in older adults in the US and UK. Paper presented at: RAND Comparative International Research Based on HRS, ELSA, SHARE Workshop; 2010 Jul 16; Santa Monica, CA. [view]
  2. McCarthy JF, Szymanski B, Pfeiffer P, Zivin K, Valenstein MT. Associations between Primary Care Provider Participation and Diagnosis Patterns. Poster session presented at: VA HSR&D Field-Based Mental Health and Substance Use Disorders Meeting; 2010 Apr 28; Little Rock, AR. [view]
  3. Zivin K. Behavioral Health Integration in the Comprehensive Primary Care Initiative. Paper presented at: Health and Aging Policy Fellows Leadership Annual Retreat; 2014 Sep 5; Washington, DC. [view]
  4. Pfeiffer PN, Ganoczy D, Zivin K, Valenstein MT. Benzodiazepines and depression: benefits to antidepressant treatment and risks of long-term use, abuse, or dependence. Paper presented at: Albert J. Silverman Research Annual Conference; 2010 May 12; Ann Arbor, MI. [view]
  5. Glass JE, Perron B, Ilgen MA, Chermack ST, Mowbray OP, Zivin K. Binge Drinking among Veterans receiving VA healthcare: who initiates specialty substance use disorder treatment? Poster session presented at: Society for Social Work and Research Annual Conference; 2010 Jan 13; San Francisco, CA. [view]
  6. Pfeiffer PN, Ganoczy D, Ilgen MA, Zivin KZ, Valenstein MT. Comorbid anxiety as a suicide risk factor among depressed veterans. Presented at: Albert J. Silverman Research Annual Conference; 2009 Jun 17; Ann Arbor, MI. [view]
  7. Zivin K. Cost-effectiveness of depression treatment: applications to the VA Health System. Poster session presented at: VA HSR&D / QUERI National Meeting; 2012 Jul 16; National Harbor, MD. [view]
  8. Zivin K, Madden JM, Graves AJ, Zhang F, Soumerai SB. Cost-related medication nonadherence among beneficiaries with depression following Medicare Part D. Paper presented at: Albert J. Silverman Research Annual Conference; 2010 May 12; Ann Arbor, MI. [view]
  9. Zivin K. Dangerous or not: evaluating the FDA citalopram warning. Paper presented at: University of Arkansas for Medical Sciences Psychiatric Research Institute Grand Rounds; 2012 Oct 24; Little Rock, AR. [view]
  10. Zivin K, Llewellyn DJ, Lang IA, Vijan S, Kabeto MU, Miller EM, Langa KM. Depression among older adults in the United States and England. Paper presented at: RAND Comparative International Research Based on HRS, ELSA, SHARE Workshop; 2010 Jul 16; Santa Monica, CA. [view]
  11. Zivin K. Depression treatment: warnings and outcomes. Examples from the VA health system. Paper presented at: Northwestern University Institute for Public Health and Medicine Grand Rounds; 2013 Feb 28; Chicago, IL. [view]
  12. Zivin K. Depression, comorbidity, and mortality: perspectives from the VA health system. Paper presented at: University of California San Diego Grand Rounds; 2012 Jan 9; San Diego, CA. [view]
  13. Zivin K, Paczkowski MM, Galea S. Economic downturns and population mental health. The Social Determinants of Mental Health: From Awareness to Action. Paper presented at: Adler Institute on Social Exclusion Annual Conference; 2010 Jun 3; Chicago, IL. [view]
  14. Zivin K. Employment support needs of VA primary care patients with mental disorders: a mixed methods approach. Paper presented at: Johns Hopkins Bloomberg School of Public Health Department of Mental Health Mixed Methods Work Group Seminar; 2012 Nov 1; Baltimore, MD. [view]
  15. Glass JE, Chermack ST, Austin KL, Flynn HA, Valenstein MT, Zivin K. Findings regarding the provision of psychotherapy in a national sample of depressed Veterans: implications for policy and practice. Paper presented at: Society for Social Work and Research Annual Conference; 2010 Jan 13; San Francisco, CA. [view]
  16. Glass JE, Perron B, Ilgen MA, Chermack ST, Mowbray OP, Zivin K. Heavy Drinking in a national sample of Veterans: racial and ethnic differences in alcohol consumption. Paper presented at: Society for Social Work and Research Annual Conference; 2010 Jan 13; San Francisco, CA. [view]
  17. Kales HC, Zivin K, Ballard C, Burgio L, Lyketsos C. In the wake of the antipsychotic black box warnings: where do we go from here with behavioral disturbances in dementia? Paper presented at: American Association for Geriatric Psychiatry Annual Meeting; 2010 Mar 5; Savannah, GA. [view]
  18. Mezuk B, Bohnert AS, Ratliff S, Lim KA, Zivin KZ. Influence of occupational stress and satisfaction on risk of depression among older workers: Evidence from the Health and Retirement Study. Poster session presented at: American Public Health Association Annual Meeting and Exposition; 2009 Nov 7; Philadelphia, PA. [view]
  19. Zivin K. Integrating mental health care into primary care: examples from the VA. Paper presented at: RAND Psychology Speaker Series; 2014 Apr 23; Arlington, VA. [view]
  20. Islam MK, Bohnert AS, Mezuk B, Ilgen MA, Kilbourne AM, Valenstein MT, Zivin K. Mental disorders and employment status in VA patients. Paper presented at: Health Policy Statistics Annual International Conference; 2010 Jan 20; Washington, DC. [view]
  21. Zivin K. Methodological considerations associated with evaluating the relationship between depression and mortality. Paper presented at: University of Pennsylvania Perelman School of Medicine Center for Clinical Epidemiology and Biostatistics Seminar; 2012 Mar 15; Philadelphia, PA. [view]
  22. Zivin K. Outpatient collaborative care for depression: Primary Care - Mental Health Integration in the VA Health System. Paper presented at: VA Philadelphia VAMC Grand Rounds; 2012 Mar 14; Philadelphia, PA. [view]
  23. Burnett-Ziegler IE, Ilgen MA, Zivin K. Perceptions of quality of care among Veterans with psychiatric disorders. Paper presented at: Association for Behavioral and Cognitive Therapies Annual Convention; 2010 Nov 1; San Francisco, CA. [view]
  24. Zivin K. Predictors of employment and productivity among returning National Guard members. Paper presented at: Military Family Research Institute International Research Symposium for Military Families; 2013 Jun 18; Indianapolis, IN. [view]
  25. McCarthy JF, Szymanksi B, Pfeiffer PN, Zivin K, Valenstein MT. Primary Care-Mental Health Integration in the Veterans Affairs Health System: Associations Between Primary Care Provider participation and Diagnosis Patterns. Paper presented at: Albert J. Silverman Research Annual Conference; 2010 May 12; Ann Arbor, MI. [view]
  26. McCarthy JF, Szymanski B, Pfeiffer P, Zivin K, Valenstein MT. Primary Care-Mental Health Integration in the Veterans Affairs Health System: Associations Between Primary Care Provider Participation, and Diagnosis Patterns. Poster session presented at: AcademyHealth Annual Research Meeting; 2010 Jun 27; Boston, MA. [view]
  27. McCarthy JF, Szymanski B, Pfeiffer P, Zivin K, Valenstein MT. Primary Care-Mental Health Integration in the Veterans Health System: Associations Between Primary Care Provider Participation and Diagnosis Patterns. Paper presented at: VA Implementing a Public Health Model for Meeting the Mental Health Needs of Veterans Annual Mental Health Conference; 2010 Jul 27; Baltimore, MD. [view]
  28. Evans J, Zivin K, Weintraub D, Mamo D, Kales HC. Psychopharmacology in Older Adults: Safety, Risk and Opportunities. "Examining the Link Between Antipsychotics and Mortality in VA National Data". Paper presented at: American Association for Geriatric Psychiatry Annual Meeting; 2011 Mar 18; San Antonio, TX. [view]
  29. Zivin K. Questions and controversy surrounding the FDA warning for citalopram. Paper presented at: Dartmouth Center for Aging Research Group Meeting; 2014 May 12; Waterville Valley, NH. [view]
  30. Eisenberg D, Downs MF, Golberstein E, Zivin KZ. Stigma and help-seeking for mental health among college students. Poster session presented at: AcademyHealth Annual Research Meeting; 2009 Jun 29; Chicago, IL. [view]
  31. Zivin K. The effects of genetic and psychosocial factors on late-life depression trajectories. Paper presented at: Environment, Molecules, and Population Health Seminar; 2013 Apr 23; New York, NY. [view]
  32. Zivin K, Campbell DG, Chaney EF, Bonner LM, Valenstein MT, Waltz TJ, Rubenstein LV. The longitudinal relationship between depression and employment among VA primary care patients. Paper presented at: American Statistical Association Joint Statistical Annual Meeting; 2012 Aug 2; San Diego, CA. [view]
  33. Zivin K. Trends and policy issues for psychiatric medications. Paper presented at: AcademyHealth Annual Research Meeting; 2012 Jun 24; Orlando, FL. [view]
  34. Zivin K, Kales HC, Kim HC, Valenstein MT, Chiang C, Ignacio R, Ganoczy D, Cunningham F, Schneider LS, Blow FC. Trends in antipsychotic use in dementia 1999-2007: worries, whispers and warnings. Paper presented at: Health Policy Statistics Annual International Conference; 2010 Jan 20; Washington, DC. [view]
  35. Zivin K. Trends in depressive symptom burden among older adults in the United States from 1998 to 2008. Paper presented at: Gerontological Society of America Annual Scientific Meeting; 2012 Nov 14; San Diego, CA. [view]
  36. Zivin K. What's next: depression and mental health services research in the post-CDA era. Paper presented at: VA HSR&D Career Development Annual Meeting; 2014 Feb 12; Washington, DC. [view]
  37. Zivin K, Pfeiffer PN, Ilgen MA, Welsh DE, McCarthy JF, Valenstein MT, Miller EM, Kales HC. Years of potential life lost associated with depression among Veterans. Poster session presented at: American Association for Geriatric Psychiatry Annual Meeting; 2012 Mar 16; Washington, DC. [view]


DRA: Mental, Cognitive and Behavioral Disorders, Health Systems
DRE: Treatment - Observational, Prognosis
Keywords: Depression
MeSH Terms: none

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