Motivational Interviews for Depression in Primary Care

Inclusion Criteria

• Women and men aged 18 or older presenting at one of the seven DHH study clinics with a new treatment episode for depression will be considered for the study.
• The PHQ-9 is used to define depression category with a sensitivity and specificity for MDD of at least 88%. Patients must have PHQ-9≥10 to ensure sufficient severity to warrant intervention.
• A new treatment episode is defined as no treatment with an antidepressant medication for emotional problems over the previous 90 days, nor evidence-based psychotherapy for depression.
• The subjects must have major depression as determined by diagnostic schedule.

Exclusion Criteria

• Receipt of an antidepressant medication in the previous 90 days other than a low-dose TCA for pain or Trazodone for sleep (e.g. amitriptyline ≤ 50 mg a day or Trazodone ≤ 100 mg at night).
• Current interpersonal or cognitive behavioral psychotherapy that focuses on depression.
• Female subjects who are either pregnant or nursing.
• Subjects with drug or alcohol dependency or abuse (except for nicotine or caffeine) within the preceding 6 months.
• High risk for suicide.
• Inability to communicate in English.
• No personal telephone or homeless.
• Lifetime bipolar disorder.
• Psychosis.
• Subjects with a lifetime history of autism, mental retardation, or pervasive developmental disorders.
• Subjects with uncorrected hypothyroidism or hyperthyroidism.
• Serious, unstable illnesses including hepatic, renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, immunologic, or hematologic disease.