Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effectiveness and Cost-effectiveness of a Collaborative Stepped Care Intervention for the Treatment of Common Mental Disorders in Primary Care Settings in Goa, India
Brief Summary: Depressive and anxiety disorders (termed as 'Common Mental Disorders') affect as many as one in four persons attending primary care; most patients do not receive effective treatments. Although the integration of mental health in primary care is accepted as the only feasible way of managing Common Mental Disorders in developing countries, there is no evidence demonstrating how this can be done in a manner which is effective and affordable. The hypothesis of this trial is that a Collaborative Stepped Care package will be both clinically and cost-effective for the treatment of Common Mental Disorders in primary care.


Options:
A: Inclusion Criteria:

* Age above 18;
* Suffering from a Common Mental Disorder (as defined by an a priori cut-off score on the 12 item General Health Questionnaire)
* Resident in the state (Goa) for the subsequent 12 months
* Not requiring urgent medical/surgical attention (e.g hospital admission)

Exclusion Criteria:

* Suffering from a cognitive or sensory impairment which makes participation in the evaluation difficult
* Not speaking Konkani, Marathi, Hindi or English
B: Inclusion Criteria:

1. Individuals with Chinese ethnicity, defined as people who self-identify as being Chinese based upon having either one or both parents being ethnic Chinese.
2. Monolingual Chinese American immigrants, defined as people who require or prefer to be interviewed in Chinese (including Cantonese, Taiwanese, Mandarin, and Toisanese dialects).
3. Men or women age 18 or older, who live in the greater Boston area.
4. Individuals who are competent to consent and have completed a written consent form.
5. Individuals who have a PCP.
6. Patients who screen positive for MDD, current according to the fourth version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) as diagnosed by the Mini International Neuropsychiatric Interview (MINI; Sheehan et al, 1998)
7. Individuals who are willing to receive phone interviews for monitoring of symptoms and for additional support (care management) if available.

Exclusion Criteria:

1. Patients with serious suicidal risk.
2. Patients with unstable medical illnesses requiring imminent hospitalization or rendering patients unsuitable for clinical interview.

d. Patients with comorbid severe mental disorders including:

1. Organic mental disorders.
2. Alcohol or substance abuse disorders active within the last year.
3. Schizophrenia.
4. Delusional disorder.
5. Psychotic disorders not elsewhere classified.
6. Bipolar disorder. e. Patients with history of treatment by a psychiatrist in the past 4 months.
C: Inclusion Criteria:

* MINI diagnosed Anxiety Disorder (PTSD, GAD, SAD, PD)
* Speak English or Spanish (English only at UAMS site)

Exclusion Criteria:

* Diagnosis of Bipolar 1
* Drug and alcohol dependence; or abuse of any substance other than marijuana and alcohol
* Acute suicidality or homicidality

Eligible subjects must be current patients at one of the participating primary care clinics which include:

University of Washington:

* Harborview's Adult Medicine Clinic
* Harborview's Family Medicine Clinic
* UWMC's General Internal Medicine Clinic at Roosevelt Clinic
* PSNHC's 45th Street Clinic
* Country Doctor Community Clinic
* Carolyn Downs Family Medical Center

UCLA:

* Desert Medical Group, Palm Springs CA
* High Desert Medical Group, Lancaster, CA

UCSD:

* Kaiser Permanente, Bonita Medical Offices
* Kaiser Permanente, Otay Mesa Outpatient Medical Center
* UCSD Medical Center, Scripps Ranch Medical Office
* UCSD Medical Center, Fourth and Lewis Medical Office
* UCSD Medical Center, Perlman Ambulatory Care Center
* Sharp Rees-Stealy Medical Group, El Cajon
* Sharp Rees-Stealy Medical Group, Mira Mesa

UAMS:

* UAMS UPMG
* Little Rock Diagnostic Clinic
* St. Vincent's Family Clinic South
D: Inclusion Criteria:

* African American
* ≥55 years of age
* English speaking
* Cognitively intact (MMSE \>24)
* Depressed as measured by a score ≥5 on the PHQ-9
* Must have a telephone
* Planning to live in the area for 8 months

Exclusion Criteria:

* Not African American
* \<55 years of age
* Does not speak English
* MMSE\<24
* Not depressed as measures by a score of \<5 on the PHQ-9
* Does not have a telephone
* Does not plan to live in the area for 8 months

Answer: A