| This dissertation is comprised of three papers that explore the relationship between depression and medical disorders, specifically diabetes and heart disease. Each paper focuses on a different element of this relationship, namely diagnosis of depression (paper 3), treatment of depression (paper 2), and adherence to antidepressant treatment (paper 1) among patients with comorbid medical illness.; In my first paper, I examined the effect of antidepressant adherence on glycemic control among diabetes patients. The analysis did not detect significant differences in HbA1c levels (a measure of glycemic control) over time among diabetes patients who were and were not adherent to antidepressant medication treatment.; My second paper looked at the effect of a medical crisis counseling intervention on self-rated health among cardiac patients who were identified with symptoms of emotional distress. In this randomized controlled trial, intervention patients had significantly higher levels of self-rated health improvement compared to control patients at two months post-baseline.; My final paper evaluated how well a depression and anxiety assessment tool predicted a major depression diagnosis among cardiac patients. This analysis found that an assessment tool was highly sensitive but not very specific at a predetermined cutoff level for detecting major depression. It also found that a few items on the assessment tool could reasonably predict depression diagnosis almost as well as the entire assessment measure. |
