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Individual and neighborhood characteristics as predictors of depression symptom response.

Panaite V, Bowersox NW, Zivin K, Ganoczy D, Kim HM, Pfeiffer PN. Individual and neighborhood characteristics as predictors of depression symptom response. Health services research. 2019 Jun 1; 54(3):586-591.

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Abstract:

OBJECTIVE: Assess whether neighborhood characteristics predict patient-reported outcomes for depression. DATA SOURCES: VA electronic medical record data and U.S. census data. STUDY DESIGN: Retrospective longitudinal cohort. DATA EXTRACTION METHODS: Neighborhood and individual characteristics of patients (N  =  4,269) with a unipolar depressive disorder diagnosis and an initial Patient Health Questionnaire (PHQ-9) score = 10 were used to predict 50 percent improvement in 4-8-month PHQ-9 scores. PRINCIPAL FINDINGS: The proportion of a patient's neighborhood living in poverty (OR  =  0.98; 95% CI: 0.97-.1.00; P  =  0.03) was associated with lower likelihood of depression symptom improvement in addition to whether the patient was black (OR  =  0.76; 95% CI:0.61-0.96; P  =  0.02) had PTSD (OR  =  0.59; 95% CI:0.50-0.69; P  <  0.001) or had any service-connected disability (OR  =  0.73; 95% CI:0.61-0.87; P  <  0.001). CONCLUSIONS: Neighborhood poverty should be considered along with patient characteristics when determining likelihood of depression improvement.





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