BACKGROUND: Both antenatal and postpartum @entity308 have adverse, lasting effects on maternal and @entity1 well-being. Socioeconomically disadvantaged @entity1 are at increased risk for perinatal @entity308 and have experienced difficulty accessing evidence-based @entity308 care. The authors evaluated whether "MOMCare,"a culturally relevant, collaborative care intervention, providing a choice of brief interpersonal psychotherapy and/or antidepressants, is associated with improved quality of care and depressive outcomes compared to intensive public health Maternity Support Services (MSS-Plus). METHODS: A randomized multisite controlled trial with blinded outcome assessment was conducted in the Seattle-King County Public Health System. From January 2010 to July 2012, pregnant @entity1 were recruited who met criteria for probable major @entity308 , English-speaking, had telephone access, and >= 18 years old. The primary outcome was @entity308 severity at 3-, 6-, 12-, 18-month postbaseline assessments; secondary outcomes included functional improvement, @entity1005 severity, @entity308 response and remission, and quality of @entity308 care. RESULTS: All @entity1 were on Medicaid and 27 years old on average; 58% were non-White; 71% were unmarried; and 65% had probable @entity1005 . From before birth to 18 months postbaseline, MOMCare (n = 83) compared to MSS-Plus @entity1 (n = 85) attained significantly lower levels of @entity308 severity (Wald's   (2) = 6.09, df = 1, P = .01) and @entity1005 severity (Wald's   (2) = 4.61, df = 1, P = .04), higher rates of @entity308 remission (Wald's   (2) = 3.67, df = 1, P = .05), and had a greater likelihood of receiving >= 4 mental health visits (Wald's   (2) = 58.23, df = 1, P < .0001) and of adhering to antidepressants in the prior month (Wald's   (2) = 10.00, df = 1, P < .01). CONCLUSION: Compared to MSS-Plus, MOMCare showed significant improvement in quality of care, @entity308 severity, and remission rates from before birth to 18 months postbaseline for socioeconomically disadvantaged @entity1 . Findings suggest that evidence-based perinatal @entity308 care can be integrated into the services of a county public health system in the United States. CLINICAL TRIAL REGISTRATION: ClinicalTrials.govNCT01045655.

COLLABORATIVE CARE FOR PERINATAL DEPRESSION IN SOCIOECONOMICALLY DISADVANTAGED XXXX : A RANDOMIZED TRIAL.

@entity1 :: ('9606', 'Species') :: ['participants', 'women', 'child'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression', 'depression and/or dysthymia'] @entity1005 :: ('MESH:D013313', 'Disease') :: ['PTSD']
@entity1 :: (9606,Species) :: ['WOMEN']
