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The COVID-19 pandemic caused disruption to health services. It is unclear if there were inequalities in the continuity of mental health care in the years around the COVID-19 pandemic. We used electronic health records (EHR) to detect mental health care gaps of more than six months in psychiatric appointments across demographic and socioeconomic characteristics among patients with depression. The analysis included patients with depression who were seen at one of two mental health clinics every year of 2018, 2019, 2021, and 2022 (n = 783 patients). First, we found that the odds of mental health care gaps significantly decreased in the post-pandemic period (2021-2022) relative to the pre-pandemic period (2018-2019). Second, in the pre-pandemic period, patients who lived in areas in the highest tertile of deprivation had greater odds of gaps in mental health care relative to those in the lowest tertile (aOR: 2.18 [95 % CI: 1.02, 4.68]). Males had higher odds of gaps in care than females in the post-pandemic period (aOR: 2.22 [1.13, 4.37]) and the pooled pre- and post-pandemic study period (aOR: 1.58 [1.04, 2.40]). Third, interactions between patient characteristics and time were not significant, suggesting that the change in the odds of gaps of mental health care before relative to after the COVID-19 pandemic did not differ significantly based on patient characteristics. Overall, gaps in care decreased in the post-pandemic period relative to the pre-pandemic period among almost all patient groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Dr. Mojtabai reports having received royalties and consulting fees from UpToDate, Medscape, and MindMed and providing expert consultation regarding social media litigation on behalf of the plaintiffs. The other authors report no financial relationships with commercial interests., (Copyright © 2025. Published by Elsevier B.V.)

Purpose: The aim of this literature review is to examine evidence of time trends and birth cohort effects in depressive disorders and symptoms among US adolescents in peer-reviewed articles from January 2004 to April 2022., Methods: We conducted an integrative systematic literature review. Three reviewers participated at different stages of article review. Of the 2234 articles identified in three databases (Pubmed, ProQuest Central, Ebscohost), 10 met inclusion criteria (i.e., adolescent aged United States populations, included information about birth cohort and survey year, focused on depressive symptoms/disorders)., Results: All 10 articles observed increases in depressive symptoms and disorders in adolescents across recent survey years with increases observed between 1991 and 2020. Of the 3 articles that assessed birth cohort trends, birth cohort trends were less prominent than time period trends. Proposed explanations for increases included social media, economic-related reasons, changes in mental health screening and diagnosis, declining mental health stigma, increased treatment, and, in more recent years, the COVID-19 pandemic., Conclusions: Multiple cross-sectional surveys and cohort studies documented rising prevalence of depressive symptoms and disorder among adolescents from 1991 to 2020. Mechanisms driving this increase are still unknown. Research to identify these mechanisms is needed to inform depression screening and intervention efforts for adolescents., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Purpose: To assess the concurrent validity of a single question on medication use for depression in a general population survey., Methods: Using data from 2015 to 2016 and 2017 to 2018 National Health and Nutrition Examination Survey, we compared responses to a single question on medication use for depression with responses to a detailed questionnaire confirmed by inspecting medication packages or pharmacy printouts., Results: There was a strong agreement (96.4%) between response to a single question about using medication for depression and responses to questions about using antidepressants or other psychiatric medications for depression on the detailed questionnaire. The single-question assessment had excellent sensitivity (93.8%) and specificity (96.7%), positive predictive value (71.5%), and kappa (0.79). Psychometric properties were mostly consistent across population subgroups., Conclusions: Single-question assessments of medication use for depression have acceptable concurrent validity against more detailed assessments and provide an efficient method for assessing medication treatment of depression in population health surveys., (© 2021 John Wiley & Sons Ltd.)

Introduction: Depression screening is universally recommended for adolescents presenting in primary care settings in the U.S. However, little is known about how depression screening affects the likelihood of being diagnosed with a mental disorder or accessing mental health care over time., Methods: This longitudinal cohort study used insurance claims data from adolescents who attended a well-visit between 2014 and 2017. Propensity score matching was used to compare adolescents who were screened for depression with similar unscreened adolescents. Diagnoses and treatment uptake were examined over a 6-month follow-up and included depression diagnoses, mood-related diagnoses, antidepressant medications, any mental health medication, and psychotherapy. Heterogeneity of associations by sex was also examined. Analyses were conducted from December 2020 to June 2021., Results: The sample included 57,732 adolescents (mean age, 14.26 years; 48.9% female). Compared with adolescents who were not screened for depression, adolescents screened for depression were 30% more likely to be diagnosed with depression (risk ratio=1.30, 95% CI=1.11, 1.52) and 17% more likely to receive a mood-related diagnosis (risk ratio=1.17, 95% CI=1.08, 1.27) but were not more likely to be treated with an antidepressant medication (risk ratio=1.11, 95% CI=0.82, 1.51), any mental health medication (risk ratio=1.15, 95% CI=0.87, 1.53), or psychotherapy (risk ratio=1.13, 95% CI=0.98, 1.31). Associations were generally stronger among female adolescents., Conclusions: Adolescents who were screened for depression during a well-visit were more likely to receive a diagnosis of depression or a mood-related disorder in the 6 months after screening. Future research should explore methods for increasing treatment uptake after screening., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Importance: The prevalence of internalizing problems among US adolescents has risen in the past decade. The extent to which concerns about school violence or shootings are associated with risk of internalizing problems is unknown., Objective: To examine the prospective association of concern, worry, and stress related to school violence or shootings with internalizing problems and to examine sex and racial and ethnic differences in the magnitude of the associations., Design, Setting, and Participants: This longitudinal cohort study involved 3 surveys administered 6 months apart (fall of grade 11 [prebaseline]; spring of grade 11 [baseline]; and fall of grade 12 [follow-up]) from 2015 to 2016. Participants included 2263 students from 10 high schools in Los Angeles, California. Analyses were performed from April 29, 2020, to April 8, 2021., Exposures: Baseline self-reported level of concern, worry, and stress about shootings or violence at the student's school or other schools, each rated on 5-point scales (ranging from not at all [0] to extremely [4]) with a mean score calculated as a 3-item composite index rescaled into z-score standard deviation units., Main Outcomes and Measures: Surpassing clinically significant or borderline significant thresholds for major depressive disorder, generalized anxiety disorder, or panic disorder based on symptom ratings on the Revised Children's Anxiety and Depression Scale at 6-month follow-up., Results: Of the 2263 students included in the analyses (1250 [55.2%] girls; mean [SD] age, 16.5 [0.4] years), appreciable proportions reported being very or extremely concerned (850 0f 2226 [38.2%]), worried (703 of 2209 [31.8%]), or stressed (332 of 2183 [15.2%]) about shootings or violence at their school or other schools. After adjusting for prebaseline covariates, concerns about school violence or shootings were associated with clinically significant generalized anxiety symptoms (odds ratio [OR], 1.31; 95% CI, 1.15-1.50) and panic symptoms (OR, 1.18; 95% CI, 1.05-1.32), but not depressive symptoms (OR, 1.13; 95% CI, 0.99-1.30) at the 6-month follow-up. There was a significant association between concern with school violence or shootings and depressive symptoms for Black youth (OR, 3.15; 95% CI, 1.38-7.19) and non-Hispanic/Latinx White youth (OR, 1.62 [95% CI, 1.25-2.09]) but not for youth of other races and ethnicities (OR for Asian, 1.26 [95% CI, 0.86-1.85]; OR for Hispanic/Latinx, 0.94 [95% CI, 0.76-1.16]; OR for other, 0.93 [95% CI, 0.54-1.61]). Sex did not moderate these associations., Conclusions and Relevance: The findings of this study suggest that concern, worry, and stress related to school violence or shootings may be risk factors for internalizing problems among adolescents, with variation in the strength of the association by race/ethnicity.

Background: WHO recommends the use of psychological interventions as first-line treatment for depression in low-income and middle-income countries. However, evaluations of the effectiveness and cost-effectiveness of such interventions among people with HIV are scarce. Our aim was to establish the effectiveness of group support psychotherapy (GSP) delivered by lay health workers for depression treatment among people living with HIV in a rural area of Uganda on a large scale., Methods: In this cluster-randomised trial, we included 30 health centres offering HIV care. These were randomly assigned to deliver either GSP or group HIV education (GHE). Randomisation, in a ratio of 1:1, was achieved by health centre managers separately picking a paper containing the intervention allocation from a basket. Participants were people living with HIV, aged 19 years and older, with mild to moderate major depression assessed with the Mini International Neuropsychiatric Interview depression module, taking antiretroviral therapy, and antidepressant-naive. Group sessions were led by trained lay health workers once a week for 8 weeks. The primary outcomes were the proportion of participants with major depression and function scores at 6 months post-treatment, analysed by intention to treat by means of multilevel random effect regression analyses adjusting for clustering in health centres. This trial is registered with the Pan African Clinical Trials Registry, PACTR201608001738234., Findings: Between Sept 13 and Dec 15, 2016, we assessed 1473 individuals, of whom 1140 were recruited from health centres offering GSP (n=578 [51%]) or GHE (n=562 [49%]). Two (<1%) participants in the GSP group were diagnosed with major depression 6 months post-treatment compared with 160 (28%) in the GHE group (adjusted odds ratio=0·01, 95% CI 0·003-0·012, p<0·0001). The mean function scores 6 months post-treatment were 9·85 (SD 0·76) in the GSP group and 6·83 (2·85) in the GHE group (β=4·12; 95% CI 3·75-4·49, p<0·0001). 36 individuals had 63 serious adverse events, which included 25 suicide attempts and 22 hospital admissions for medical complications. The outcomes of these serious adverse events included 16 deaths, 4 of which were completed suicides (GSP=2; GHE=2), and 12 of which were HIV-related medical complications (GSP=8; GHE=4). Cost-effectiveness estimates showed an incremental cost-effectiveness ratio of US$13·0 per disability-adjusted life-year averted, which can be considered very cost-effective in Uganda., Interpretation: Integration of cost-effective psychological treatments such as group support psychotherapy into existing HIV interventions might improve the mental health of people living with HIV., Funding: MQ Transforming Mental Health and Grand Challenges Canada., (Copyright © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Background: Primary care providers encounter a large proportion of the population with depression. Yet, many primary care patients with depression remain undiagnosed and untreated., Objective: This study aims to examine depression screening patterns and the role of screening in depression diagnosis and treatment in the outpatient primary care setting., Design: This is a cross-sectional analysis of nationally representative survey data of visits to outpatient physician offices from the 2005 to 2015 National Ambulatory Medical Care Surveys., Participants: The sample included the first visit in the past year to a primary care provider by patients 12 years and older (N = 16,887)., Methods: The associations of visit characteristics with depression screening and of depression screening with depression diagnosis and treatment during the visit were assessed using logistic regression. Logistic regression with propensity score weighting was used to estimate the odds of depression diagnosis and treatment under the counterfactual scenario in which patients who visited providers with lower depression screening rates had visited providers with higher screening rates instead. All models were adjusted for patient and visit characteristics., Key Results: A small proportion of sample visits involved depression screening (3.0%). Visits by patients with depressive symptom complaints were associated with higher odds of depression screening than other visits. When visits were weighted to have similar demographic and clinical characteristics, visits to providers with higher screening rates had higher odds of diagnosis (OR = 1.99, p < 0.001) and treatment (OR = 1.61, p = 0.001) compared to visits to providers with lower screening rates., Conclusions: Physicians appear to use depression screening selectively based on patients' presenting symptoms. Higher screening rates were associated with higher odds of depression diagnosis and treatment, and even modest increases in screening rates could meaningfully increase population-level rates of depression identification and treatment in primary care. Future research is needed to identify barriers to depression care and implement systematic interventions to improve services and patient outcomes.

We describe the process evaluation for a randomized controlled trial that compared group support psychotherapy (GSP) with group HIV education for treatment of depression among people with HIV. Process data were obtained using mixed methods. Variables evaluated were indicators of feasibility and acceptability; causal mediating processes and contextual influences. GSP was feasible and acceptable. Potential mediating variables between GSP and reduction of depression were improved emotional and social support, better coping strategies, and pursuit of livelihoods. Culturally sensitive intervention content facilitated intervention delivery. These data complement the trial outcomes, and may provide a contextualized description of how GSP treats depression.

Pay-for-value initiatives include both depression and smoking screening. Evaluating how patterns of care differ for an established screening (smoking) versus newer screening (depression) can help programs better implement these measures. Our objective is to evaluate (1) patterns of smoking and depression screening and (2) how patient factors affect screening patterns. We analyzed retrospectively collected electronic health record data from 4,763 Medicare-patients in 34 primary care practices between 2010 and 2012. The relationship between multimorbidity, history of stroke, and having depression on receipt of screening was evaluated. The outcome variables were no screening, smoking screening only, or concurrent smoking and depression screening. Fifty percent of patients were screened for smoking at every visit and never screened for depression (n = 2,378). Twelve percent of patients with ≥five visits received both depression and smoking-status screens on each of their first five visits. Screening patterns varied significantly across sites. For example, one site screened approximately 87% of patients for both depression and smoking-status at every visit. Another site screened 93% of patients for smoking during the first visit but did not conduct depression screening. Programs considering initiating new screenings should evaluate the clinic-specific workflow of successful screenings and integrate new screenings using the same strategy.

The 2016 recommendation statement by the U.S. Preventive Services Task Force (USPSTF) endorsed screening for depression in the general adult population. The recommendation was mainly based on studies that compared enhanced depression care that included depression screening with usual care. In contrast to the USPSTF recommendation, the 2013 guidelines from the Canadian Task Force on Preventive Health Care (CTFPHC) recommended against routine depression screening. The CTFPHC could not identify any studies comparing depression outcomes of usual care with and without the addition of routine depression screening. In the absence of evidence of clinical benefit, there are concerns that wide adoption of the USPSTF recommendation for universal depression screening would lead to overdiagnosis of depression and an increase in inappropriate prescription of antidepressant medications.

Objective: To compare self-ratings of depressed mood in middle-aged and older adults in the United States and nine European countries after adjustment by anchoring vignettes., Method: Samples were drawn from three large surveys of middle-aged and older adults: the U.S. Health and Retirement Study, the English Longitudinal Study of Aging (ELSA), and the Survey of Health, Ageing and Retirement in Europe. Self-ratings of depressed mood were compared across countries before and after adjustment by anchoring vignettes depicting cases with different levels of depressed mood., Results: Compared with Europeans as a group, Americans rated both the cases presented in the vignettes and themselves as more depressed. However, after adjustment by vignette ratings, Americans appeared to be less depressed than their counterparts in all but two European countries., Discussion: Cultural differences in mental health norms reflected in vignette rating may partly explain between-country differences in self-reported depressive symptoms and perhaps other psychiatric complaints., (© The Author(s) 2015.)

Using population-based data, we examined associations between alcohol use disorders (AUD) and suicidality, assessing effect modification by mood disorders, and mediation by drinking level. Suicidality was assessed among current drinkers with 2-weeks of low mood (n = 9,173) in the National Epidemiologic Survey on Alcohol and Related Conditions. Independent of mood disorder, alcohol dependence, was associated with suicidal ideation (adjusted odds ratio [AOR] = 1.64; 95% confidence interval [CI] = 1.25-2.14), and suicide attempts (AOR = 2.02; CI = 1.43-2.85) relative to those without AUD. Findings indicate partial mediation by consumption. Associations between AUD and suicidality among those with low mood are not explained by comorbid mood disorder, but are partially mediated by drinking level. Future studies should evaluate transitions in suicidality with change in consumption.

Objective: Depression screening is a required part of an initial annual wellness visit (AWV), a benefit for Medicare Part B beneficiaries. It is uncertain whether AWVs will increase depression screening. This study assessed whether patients with an AWV were more likely to be screened for depression than those with a primary care visit., Methods: A cross-sectional analysis of electronic health record data was conducted for 4,245 Medicare patients who had at least one primary care visit at one of 34 practices within a large multisite provider network between September 2010 and August 2012. Quota sampling was used so that half of the participants had an AWV and half had a randomly selected primary care visit during the study period (the index visit). Multilevel logistic regressions were used to determine whether patients with an AWV had increased odds of depression screening compared with patients with a primary care visit, after adjustment for physician and clinic clustering., Results: Fifteen percent of patients with non-AWVs and 10% of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type. There was a strong site effect, with one site conducting screening during 78% of AWVs and 82% of non-AWVs. Six sites screened none of their patients., Conclusions: Overall, depression screening during the index AWV was uncommon. By itself, the AWV benefit does not appear to be a strong enough incentive to increase depression screening.

Objectives: To evaluate conformance to depression screening, management, and outcome quality indicators and to evaluate individual characteristics associated with conformance to these indicators., Design: Cross-sectional study using electronic health record (EHR) data., Setting: Thirty-four clinics in one healthcare system., Participants: Medicare beneficiaries aged 65 and older with at least one primary care visit between September 2010 and August 2012 (N = 5,000)., Measurements: Seven measures, current as of 2013, were found for which all the necessary specifications were available in the EHR: general screening, screening within 4 months of diagnosis, screening after stroke, screening after heart disease, depression reassessment, depression response, and depression remission. Multilevel logistic regression analyses were used to determine factors associated with conformance., Results: Screening for depression in Medicare beneficiaries was low (17%). Conformance to measures varied from 10% for the depression response measure to 77% for the depression remission measure. In the adjusted regression analyses for the general screening (adjusted odds ratio (AOR) = 1.45, 95% confidence interval (CI) = 1.01-2.08), depression reassessment (AOR = 4.19, 95% CI = 1.16-15.19), and screening after heart disease (AOR = 5.57, 95% CI = 1.37-22.57) measures, black participants were more likely to be given care that conformed to the numerator criteria than white participants. A strong site effect was found, with 90% of the depression screens being administered at three sites., Conclusion: Only a small proportion of Medicare beneficiaries received the recommended screening and follow-up care needed to conform to the quality measures for depression in the primary care setting. Further evaluation of measures of depression care should be conducted before these measures are implemented widely., (© 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.)

Background: Psychotherapy is the recommended first line treatment for mild to moderate depression. However, its availability in low resource settings is limited. We developed a manualized culturally sensitive group support psychotherapeutic intervention for depressed HIV affected Ugandan adults. In this study, we aimed to assess its feasibility, acceptability and impact on depression, functioning, social support and self-esteem., Methods: A total of 77 depressed individuals were assigned to the group intervention (n=48) and a wait-list control group (n=29), and assessed before, during and at the end of the intervention. The self-reporting questionnaire, a locally relevant function assessment instrument, the Rosenberg self-esteem scale, and the multiple dimensions perceived social support scale were administered to assess depression symptoms, functioning, self-esteem and social support at three assessment periods. Multivariate longitudinal regression models were used to determine change in outcomes over time between the two groups. Participants were asked to evaluate the intervention., Results: Post -intervention assessments indicate that, in comparison to the wait-list control group, the intervention group had a faster reduction in depression symptom scores [OR=0.00,95% CI, 0.00-0.003] and faster increase in functioning scores [OR=4.82, 95% CI, 2.39 to 9.75], social support scores [OR=2.68, 95% CI, 1.50-4.78] and self-esteem [OR=1.90, 95% CI 1.48-2.44]. Sixty-three percent of participants strongly agreed that the intervention had reduced their depression and would recommend it to other depressed individuals., Limitations: Inadequate study power due to small sample sizes may result in imprecise confidence intervals even when there are significant differences. The use of non-random samples could have resulted in selection bias., Conclusions: This intervention appears feasible, acceptable and promising in treating depression and restoring function, enhancing social support and self-esteem. Larger and randomized evaluations are warranted., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Background: Depression is ranked first among neuropsychiatric diseases that contribute to the burden of disease in low- and middle-income countries. However, access to antidepressants is limited and there is a dearth of locally developed psychotherapeutic interventions targeted to treat depression., Aim: We aimed to obtain information on the cultural understanding of depression symptoms, complications and treatment methods used in post-conflict communities in northern Uganda in order to inform the development of an indigenous group support intervention to treat depression., Methods: Focus group discussions (FGDs) were conducted with a total of 110 men and women aged 19-68 years. FDGs took place in a private space, lasted about 2-3h and were conducted in the local language for patients and their caregivers and in English for health workers. Interview transcripts from the FGDs were reviewed for accuracy, translated into English and transcribed. QRS Nvivo 10 qualitative data analysis software was used for coding and thematic analysis., Results: Our study revealed community misperceptions about etiology, presentation and treatment of depression. Regardless of HIV status, most FGD participants who were not health workers linked depression symptoms to HIV infection. Although there were concerns about confidentiality of issues disclosed, many FGD participants were supportive of a group support intervention, tailored to their gender and age, that would not only focus on treating depression but also provided them with skills to improve their livelihoods. Simple CBT techniques were deemed culturally appropriate and acceptable., Limitation: Generalizability of study findings may be limited given that the sample was primarily of Luo ethnicity yet there are different ethnic populations in the region., Conclusion: Local communities can directly inform intervention content. The participants׳ preferences confirmed the need for a gender-specific intervention for depression that extends beyond medications and empowers them emotionally, socially and economically., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Context: The DSM-IV criteria for major depressive episodes exclude brief episodes that are better accounted for by bereavement. However, a proposal has been made to remove this exclusion from the DSM-5., Objectives: To compare the demographic and psychiatric characteristics of participants with bereavement-related, single, brief (<2 months) depressive episodes and other types of depressive episodes and to compare the future risk of depression between these groups and participants without a history of depression at baseline., Design: A longitudinal, community-based, epidemiologic study conducted from August 1, 2001, through May 31, 2002 (wave 1), and from August 1, 2004, through September 30, 2005 (wave 2)., Setting: The US general population, including residents of Hawaii and Alaska., Participants: Participants in the National Epidemiologic Survey on Alcohol and Related Conditions waves 1 (n = 43 093) and 2 (n = 34 653)., Main Outcome Measures: Demographic characteristics, age at onset, history of depression in first-degree relatives, impairment in role functioning, psychiatric comorbidities, lifetime mental health service use, and new depressive episodes during the 3-year follow-up period., Results: Compared with participants with other types of depression, those with bereavement-related, single, brief depressive episodes were more likely to experience later onset and to be black but less likely to have had impairment in role functioning, comorbid anxiety disorders, or a treatment history at baseline. Participants with bereavement-related, single, brief episodes were less likely than those with bereavement-unrelated, single, brief episodes to experience fatigue, increased sleep, feelings of worthlessness, and suicidal ideations. The risk of new depressive episodes during the follow-up period among participants with bereavement-related, single, brief episodes was significantly lower than among participants with bereavement-unrelated, single, brief episodes and other types of depression but similar to the risk among the participants from the general population with no baseline history of depression., Conclusions: Bereavement-related, single, brief depressive episodes have distinct demographic and symptom profiles compared with other types of depressive episodes and are not associated with increased risk of future depression. The findings support preserving the DSM-IV bereavement exclusion criterion for major depressive episodes in the DSM-5.

This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4% of the screened visits compared with 16.3% of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions.

Background: Chronic care model (CCM) envisages a multicomponent systematic remodeling of ambulatory care to improve chronic diseases management. Application of CCM in primary care management of depression has traditionally lagged behind the application of this model in management of other common chronic illnesses. In past research, the use of CCM has been operationalized by measuring the use of evidence-based organized care management processes (CMPs)., Objectives: To compare the use of CMPs in treatment of depression with the use of these processes in treatment of diabetes and asthma and to examine practice-level correlates of this use., Study Design: Using data from the 2008 Health Tracking Physician Survey, a nationally representative sample of physicians in the United States, we compared the use of 5 different CMPs: written guidelines in English and other languages for self-management, availability of staff to educate patients about self-management, availability of nurse care managers for care coordination, and group meetings of patients with staff. We further examined the association of practice-level characteristics with the use of the 5 CMPs for management of depression., Results: CMPs were more commonly used for management of diabetes and asthma than for depression. The use of CMPs for depression was more common in health maintenance organizations [adjusted odds ratios (AOR) ranging from 2.45 to 5.98 for different CMPs], in practices that provided physicians with feedback regarding quality of care to patients (AOR range, 1.42 to 1.69), and in practices with greater use of clinical information technology (AOR range, 1.06 to 1.11)., Conclusion: The application of CMPs in management of depression continues to lag behind other common chronic conditions. Feedbacks on quality of care and expanded use of information technology may improve application of CMPs for depression care in general medical settings.