Culturally Sensitive Collaborative Treatment for Depressed Chinese Americans
Culturally Sensitive Collaborative Treatment for Depressed Chinese Americans
This study will evaluate the effectiveness of culturally sensitive treatment versus regular
 care in treating depressed Chinese Americans.
Depression is a complex illness that impacts an individual's thoughts, behavior, mood, and
 physical health. Research has shown that many Asian Americans with depression do not complain
 about their symptoms or seek treatment, which has lead to an under-recognition of depression
 in this population. Furthermore, even when a primary care physician does diagnose depression
 in an Asian American, adequate treatment does not often follow. There is a clear need to
 understand the cultural reasons for why treatment is not sought out by Asian Americans. There
 is also a need for developing new treatments that specifically target the Asian American
 population. Offering culturally sensitive therapies combined with traditional medical care
 may make depressed Asian Americans more comfortable in seeking treatment for their illness.
 Culturally Sensitive Collaborative Treatment (CSCT) is a comprehensive approach to treating
 depression. It incorporates consultation with a culturally trained psychiatrist, medical
 treatment provided by a primary care provider, and care management provided by a bilingual
 and bicultural care manager. The purpose of this study is to evaluate the effectiveness of
 CSCT versus traditional medical care for the treatment of depression in Chinese Americans.

 This 24-week study will enroll depressed Chinese Americans. Potential participants will be
 interviewed in primary care clinics to screen for depression. Once enrolled, all participants
 will attend a consultation with a psychiatrist trained in cultural sensitivity to introduce
 the concept and treatment of depression. Participants will then be randomly assigned to
 either CSCT or standard care. Both groups of participants will receive regular care from
 their primary care provider, but the CSCT group will also meet with a bilingual and
 bicultural care manager to learn how to fully manage their depression. Outcome measurements
 will include symptoms of depression; adherence to appointments with primary care providers;
 adherence to medication treatment; and adverse events. All measurements will be assessed
 during follow-up phone calls at Weeks 2, 6, 10, 14, 18, 22, and 24.
Inclusion Criteria:

 -  Chinese ethnicity

 -  Currently depressed as determined by a total score of at least 16 on the CBCI scale

 -  Speaks and understands English or Chinese (including Mandarin, Cantonese, and
 Taiwanese dialect)

 -  Willing to participate in follow-up phone calls

 Exclusion Criteria:

 -  Currently at risk for suicide

 -  Current unstable medical illness

 -  Current clinical or laboratory evidence of hypothyroidism

 -  Diagnosed with any of the following in addition to depression: organic mental
 disorder; schizophrenia; delusional disorder; psychotic disorder; bipolar disorder;
 mood congruent or mood incongruent psychotic features

 -  History of treatment by a psychiatrist within 4 months of study entry

 -  History of alcohol or substance abuse within 1 year of study entry