Treating Anxiety in Public Sector Medical Settings
Principal Investigator: Peter P Roy-Byrne
Affiliation: University of Washington
Abstract: DESCRIPTION (provided by candidate): This is a mid-career investigator award in patient-oriented research that is designed to strengthen my research and further the development and growth of young investigators in the application of evidence based treatments, especially for anxiety disorders, in public sector medical settings. Poor and medically disadvantaged populations are clearly underrepresented in research studies, especially in treatment studies. We clearly need more clinical investigators to work in these settings and with these populations. There also is a need for public sector research infrastructures that will support state-of-the-art research. Finally, given the deficiencies in quality of care for anxiety disorders in most medical settings, but especially the public sector, we need to know how to best tailor and deliver evidence-based treatments. My three goals for this Mid-Career Investigator Award in Patient-Oriented Research (K24) are therefore (1) to crystallize a new career research focus in translational research that would increase the relevance, speed the development, and facilitate the utilization of research-focused treatments and services interventions for anxiety disorders in the public sector medical setting; (2) to create a practice infrastructure that supports state-of-the-art research on the application of evidence based treatments in public sector medical settings; (3) to mentor junior investigators interested in research on the application of evidence-based treatments in the public sector. My broad background in clinical research will allow me to relate to the developing clinician-scientist across multiple levels of research interest and to steer them toward the field of services research. As my skills in this latter area evolve over the course of this award, I hope to be able to mentor them even more effectively in this specific area as well.
Funding Period: 2002-12-01 - 2008-08-30
more information: NIH RePORT
- A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorderPeter P Roy-Byrne
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine at Harborview Medical Center, Seattle, USA
Arch Gen Psychiatry 62:290-8. 2005..Although numerous studies have assessed the effectiveness of treatments for depression in primary care, few such studies have been conducted for panic disorder...
- Poverty and response to treatment among panic disorder patients in primary carePeter Roy-Byrne
Department of Psychiatry and Behavioral Science, University of Washington School of Medicine at Harborview Medical Center, 326 9th Ave, Seattle, WA 98104, USA
Am J Psychiatry 163:1419-25. 2006....
- CBT intensity and outcome for panic disorder in a primary care settingMichelle G Craske
University of California, Los Angeles, Los Angeles, CA 90095 1563, USA
Behav Ther 37:112-9. 2006..The significance of follow-up booster phone contact is discussed as an index of continued self-management of panic and anxiety following acute treatment...
- Panic disorderPeter P Roy-Byrne
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine at Harborview Medical Center, Seattle, WA 98104 2499, USA
Lancet 368:1023-32. 2006..The adaptation and dissemination of these treatments to the frontlines of medical-care delivery should be urgent goals for the public-health community...
- Adherence to treatment among economically disadvantaged patients with panic disorderSnigdha Mukherjee
South Central Mental Illness Research, Education and Clinical Center, North Little Rock, Arkansas, USA
Psychiatr Serv 57:1745-50. 2006..The purpose of this study was to examine the feelings of disadvantaged patients about and experiences of treatment for anxiety disorders in primary care settings...
- Relationships among pain, anxiety, and depression in primary careAdrienne J Means-Christensen
Department of Psychology, Radford University, Radford, Virginia, USA
Depress Anxiety 25:593-600. 2008..An awareness of these relationships may be particularly important in primary care settings where a patient who presents with reports of pain may have an undiagnosed anxiety or depressive disorder...
- Validation of a brief measure of anxiety-related severity and impairment: the Overall Anxiety Severity and Impairment Scale (OASIS)Laura Campbell-Sills
Department of Psychiatry, University of California, San Diego, La Jolla, CA 92093 0603, USA
J Affect Disord 112:92-101. 2009..A prior investigation with a nonclinical sample supported the reliability and validity of the OASIS; however, to date it has not been validated for use in clinical samples...
- Computer-assisted delivery of cognitive behavioral therapy for anxiety disorders in primary-care settingsMichelle G Craske
Department of Psychology, University of California, Los Angeles, California, USA
Depress Anxiety 26:235-42. 2009..The purpose of the current report is to (1) present the structure and format of the computer-assisted CBT program, and (2) to present evidence for acceptance of the program by clinicians and the effectiveness of the program for patients...
- Unmet need for mental health and addictions care in urban community health clinics: frontline provider accountsMeg Cristofalo
Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations CHAMMP, Department of Psychiatry, University of Washington School of Medicine at Harborview Medical Center, Seattle, WA 98104 2499, USA
Psychiatr Serv 60:505-11. 2009....
- Using five questions to screen for five common mental disorders in primary care: diagnostic accuracy of the Anxiety and Depression DetectorAdrienne J Means-Christensen
Department of Psychiatry, University of California, San Diego, CA 92093 0985, USA
Gen Hosp Psychiatry 28:108-18. 2006..However, before patients in primary care can be treated, they must be identified. This study set out to validate a very brief screening instrument for identifying primary care patients with anxiety and depression...
- In search of mixed anxiety-depressive disorder: a primary care studyAdrienne J Means-Christensen
Department of Psychiatry, University of California, San Diego, California, USA
Depress Anxiety 23:183-9. 2006..These data dispute the need for a mixed anxiety-depression category (beyond mood and anxiety syndromes currently in DSM-IV) in future editions of the DSM...
- Incremental cost-effectiveness of a collaborative care intervention for panic disorderWayne Katon
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, 98195 6560, USA
Psychol Med 36:353-63. 2006..This study describes the incremental cost-effectiveness of a combined cognitive behavioral therapy (CBT) and pharmacotherapy intervention for patients with panic disorder versus usual primary-care treatment...
- Use of herbal medicine in primary care patients with mood and anxiety disordersPeter P Roy-Byrne
Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington School of Medicine, Box 359911, 325 9th Ave, Seattle, WA 98104, USA
Psychosomatics 46:117-22. 2005..Use was not associated with receipt of pharmacotherapy or psychotherapy for anxiety or depression...
- Medical illness and response to treatment in primary care panic disorderPeter Roy-Byrne
Department of Psychiatry and Behavioral Science, University of Washington School of Medicine at Harborview Medical Center, WA 98104, USA
Gen Hosp Psychiatry 27:237-43. 2005..Although studies have suggested that comorbid medical illness can affect the outcome of patients with depression, little is known about whether medical illness comorbidity affects treatment outcome in patients with anxiety...
- Perceived unmet need for mental health treatment and barriers to care among patients with panic disorderMichelle G Craske
University of California, Los Angeles, CA 90024 1563, USA
Psychiatr Serv 56:988-94. 2005..This study estimated the extent of perceived unmet need for mental health treatment among individuals with panic disorder in primary care settings, investigated the determinants of unmet need, and assessed barriers to care...
- Does the addition of cognitive behavioral therapy improve panic disorder treatment outcome relative to medication alone in the primary-care setting?Michelle G Craske
Department of Psychology, University of California Los Angeles, 405 Holgard Avenue, Los Angeles, CA 90095, USA
Psychol Med 35:1645-54. 2005..Using an as-treated analysis, we evaluated whether the addition of CBT enhanced outcomes for panic disorder relative to medications alone in the primary-care setting...
- Paroxetine response and tolerability among ethnic minority patients with mood or anxiety disorders: a pooled analysisPeter P Roy-Byrne
Department of Psychiatry and Behavioral Sciences, University of Washington at Harborview Medical Center, Seattle 98104, USA
J Clin Psychiatry 66:1228-33. 2005....
- Functional impact and health utility of anxiety disorders in primary care outpatientsMurray B Stein
Department of Psychiatry, University of California San Diego, La Jolla, CA 92093 0985, USA
Med Care 43:1164-70. 2005..The objective of this study was to examine the relative impact of anxiety disorders and major depression on functional status and health-related quality of life of primary care outpatients...
- Treating minority patients with depression and anxiety: what does the evidence tell us?Trevor J Schraufnagel
Department of Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, 98104, USA
Gen Hosp Psychiatry 28:27-36. 2006..The purpose of this study is to examine the current state of knowledge regarding treating ethnic/racial minority patients with mood and anxiety disorders, emphasizing data-based studies whenever possible...
- Correlates of alcohol use among anxious and depressed primary care patientsJoanna J Arch
Department of Psychology, University of California, Los Angeles, 90095 1563, USA
Gen Hosp Psychiatry 28:37-42. 2006..The purpose of this study is to determine the patterns of alcohol use for primary care patients with anxiety disorders and/or major depression in three urban university-affiliated outpatient clinics...
- Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorderDenise A Chavira
Department of Psychiatry, University of California, San Diego, CA 92037, USA
J Nerv Ment Dis 197:715-21. 2009..A greater understanding of these predictors may help clinicians identify who is at greatest risk for persistent panic-related symptoms and to plan the intensity of interventions accordingly...