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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1089 — Social Support and Recovery Orientation among Patients in VA Depression Care: Implications for Interventions

Valenstein MBrandfon SWalters HPfeiffer PGanoczy DGarcia EHenry J, and Konarz B, Ann Arbor COE/SMITREC; Grossbard J, Seattle COE; Jarman C, Ann Arbor COE/SMITREC

Objectives:
Potentially, patients in depression treatment may benefit from increased peer support, particularly if these interactions are viewed as constructive and incorporate recovery themes. However, there have been no studies, to date, that systematically evaluate associations between depression severity, social support, and recovery orientation among VA patients in depression care. We assessed these relationships in a sample of 200 VA patients enrolled in a randomized controlled trial (RCT) of reciprocal peer support versus usual care.

Methods:
Baseline data were obtained from 200 VA patients receiving depression treatment in any of four VA Medical Centers and enrolling in an RCT of peer support. We assessed relationships between baseline depression severity, as measured by the Beck Depression Inventory (BDI-II), and social support, as measured by the Interpersonal Support Evaluation List (ISEL). We also evaluated associations between depression severity and recovery orientation, as measured by the Mental Health Recovery Measure (MHRM). Analyses were completed using descriptive statistics, bivariate analyses, and linear regression models.

Results:
Of the 200 study Veterans, 18% had minimal, 18% had mild, 28% had moderate, and 36% had severe depressive symptoms at the time of baseline data collection. In bivariate analyses, both ISEL scores and MHRM scores differed significantly by depression severity group. In linear regression analyses, adjusting for sex and age, mild, moderate, and severe depression groups were all associated with lower MHRM scores (lower recovery orientation) than the minimal depression group. The severe depression group was associated with higher ISEL scores (less perceived social support) compared to the minimal symptom group.

Implications:
Congruent with community studies, severely depressed patients in VA treatment report lower levels of social support in their natural networks compared to those with minimal symptoms. In addition, severe and moderately depressed Veterans are significantly less likely to report a recovery orientation compared to Veterans with minimal symptoms.

Impacts:
Assessing and promoting a recovery orientation may be particularly important when working with VA patients with depression. Augmentation of social support may be most helpful for the most severely depressed Veterans. Using peers to enhance social support may promote a recovery message, particularly if recovery-promoting interactions are emphasized and fostered.


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