Rates of depression tend to be higher in rural areas than in urban ones, yet rural residents may have a harder time accessing mental health care. Driving to see a psychiatrist or counselor may take hours, and wait times for an appointment may take months.
West Virginia University researcher Dr. Robert Bossarte is launching a study to compare three treatment strategies for rural depressed patients: antidepressants alone; antidepressants combined with unguided cognitive behavior therapy provided online; and antidepressants combined with guided online cognitive behavior therapy.
Dr. Bossarte, who teaches epidemiology in the West Virginia University School of Public Health and also is an associate professor in the WVU School of Medicine’s department of behavioral medicine and psychiatry says the project is focused on getting the right kind of treatment to the right patient.
“Our ultimate goal is to drive down the treatment failure rate. It’s precision medicine,” Dr. Bossarte said.
The study will include 8,000 depression patients who live in West Virginia. Dr. Bossarte will collaborate with the West Virginia Clinical and Translational Science Institute’s West Virginia Practice-Based Research Network to recruit West Virginia clinic sites to participate in the study.
“Unfortunately, major depressive disorder is very common among West Virginia’s citizens, and we have one of the highest suicide rates. As part of our mission as a School of Public Health, we are committed to serving the needs of the Mountain State. This project is focused on getting the right kind of help to those in need,” said Dr. Jeffrey Coben, dean of the WVU School of Public Health and associate vice president for health affairs at the WVU Health Sciences Center.
In the future, the data that the study generates may inform an algorithm that predicts which patients should get a recommendation to try online cognitive behavior therapy. Perhaps patients who score high in impulsivity, for instance, will benefit from it more than their less spontaneous counterparts do. Or maybe depressed patients who also have anxiety disorders will profit more than others from online therapy.
The project is sponsored by a $13.3-million award from the Patient-Centered Outcomes Research Institute and will be carried out in collaboration with the Depression and Bipolar Support Alliance of West Virginia and the Practice-Based Research Network of the West Virginia Clinical and Translational Science Institute.