***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE A culturally focused psychiatric ( CFP ) consultation service was implemented to increase engagement in mental health care and reduce depressive symptoms among adult Latino primary care patients . The aim of this study was to assess preliminary efficacy of the CFP consultation service to reduce depressive symptoms . METHODS In a r and omized controlled study , primary care clinics were r and omly selected to provide either the two-session CFP intervention or enhanced usual care . For CFP intervention participants , study clinicians ( psychologists or psychiatrists ) provided a psychiatric assessment , psychoeducation , cognitive-behavioral tools , and tailored treatment recommendations ; primary care providers were provided a consultation summary . Depressive symptoms ( as measured by the Quick Inventory of Depressive Symptomatology-Self Rated [ QIDS-SR ] ) were assessed at baseline and six-month follow-up . Multiple regression analysis was conducted to evaluate whether CFP intervention participants showed greater improvement in depressive symptoms at follow-up , with control for baseline depression , clinic site , and significant covariates . RESULTS Participants ( N=118 ) were primarily Spanish-monolingual speakers ( 64 % ) .  Although depressive symptoms remained in the moderate range for both groups from baseline to six months , symptom reduction was greater among CFP intervention participants ( mean±SD change in QIDS-SR score=3.46±5.48 ) than those in usual care ( change=.09±4.43 ) . The final multiple regression model indicated that participation in the CFP intervention predicted lower depressive symptoms at follow-up ( unst and ardized beta=-3.09 , p=.008 ) , independent of baseline depressive symptoms , clinic site , age , gender , and employment status . CONCLUSIONS Results suggest that Latinos experiencing depressive symptoms may benefit from a short-term CFP consultation . Findings also support the integration of psychiatric interventions for Latinos in the primary care setting OBJECTIVE This study examined the utilization of mental health treatments  over a three-year period among patients with schizotypal , borderline , avoidant , or obsessive-compulsive personality disorders compared with patients with major depressive disorder and no personality disorder . METHODS A prospect i ve , longitudinal study design was used to measure treatment use for 633 individuals aged 18 to 45 years during a three-year period . RESULTS Patients with borderline personality disorder were significantly more likely than those with major depressive disorder to use most types of treatment . Furthermore , all patients continued using high-intensity , low- duration treatments throughout the study period , whereas  individual psychotherapy attendance declined significantly after one year . CONCLUSIONS Although our data showed that patients with borderline personality disorder used more mental health services than those with major depressive disorder , many questions remain about the adequacy of the treatment received by all patients with personality disorders The present study investigated the effects of personality disorders ( PDs ) and specific PD-related beliefs on the results of (cognitive-)behavioral therapy for anxiety disorders in a sample of 398 out patients . The authors used a prospect i ve design in which relationships between PD variables before treatment and outcome measures at posttest and follow-up were evaluated with multilevel analyses . People with PDs and PD-related beliefs reported higher symptom levels at outcome . However , these effects were not as strong as might be expected on the basis of prevailing clinical thought in this area . Dropout rates were not influenced by the presence of 1 or more PDs or PD-related beliefs . Results indicate that treatment of anxiety disorders in patients with concomitant one or more PDs is appropriate BACKGROUND Mental health problems such as depression and anxiety are common in Multiple Sclerosis ( MS ) and are often under treated . AIMS This paper reports on the clinical effectiveness of a cognitive behaviour therapy service for common mental disorders in people with MS and compares it to previous r and omised controlled trials ( RCTs ) of cognitive behaviour therapy ( CBT ) in this population . METHODS 49 patients were deemed appropriate for CBT and 29 accepted treatment . Assessment s were completed at baseline and end of treatment and included the Hospital Anxiety & Depression Scale . Results in the form of a st and ardized effect of treatment were compared with five previous RCTs . RESULTS The results from this clinical service indicated statistically significant outcomes with reductions in depression and anxiety . The uncontrolled effect size was large but inferior to those found in published RCTs . CONCLUSIONS Cognitive behaviour therapy is effective for people with MS in routine clinical practice . Possible limits on effectiveness include more liberal patient selection , lack of specificity in rating scales and heterogeneity of target problems . Given the high rates of distress in this population , routine psychological interventions within neurology services are justifiable . Future research should aim to maximise CBT in such setting Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more The outcome of a r and omized controlled trial of cognitive behavior therapy in addition to treatment as usual ( CBT plus TAU ) compared with TAU alone ( TAU ) in one hundred and six participants meeting diagnostic criteria for borderline personality disorder is described . We anticipated that CBT plus TAU would decrease the number of participants with  in-patient psychiatric hospitalizations or accident and emergency room contact or suicidal acts over twelve months treatment and twelve months follow-up , compared with TAU . We also anticipated that CBT plus TAU would lead to improvement in a range of secondary outcomes of mental health and social functioning compared to TAU .  Of the 106 participants r and omized , follow-up data on 102 ( 96 % ) was obtained at two years . Those r and omized to CBT were offered an average of 27 sessions over 12 months and attended on average 16 ( range 0 to 35 ) . We found that the global odds ratio of a participant in the CBT plus TAU group compared with the TAU alone group having any of the outcomes of a suicidal act , in-patient hospitalization , or accident and emergency contact in the 24 months following r and omization was 0.86 ( 95 % confidence interval [ CI ] 0.45 to 1.66 , p = 0.66 ) . The corresponding global odds ratio , excluding accident and emergency room contact , was 0.75 ( 95 % CI 0.37 to 1.54 , p = 0.44 ) . In terms of the number of suicidal acts , there was a significant reduction over the two years in favor of CBT plus TAU over TAU , with a mean difference of -0.91 ( 95 % CI -1.67 to -0.15 , p = 0.020 ) . Across both treatment arms there was gradual and sustained improvement in both primary and secondary outcomes , with evidence of benefit for the addition of CBT on the positive symptom distress index at one year , and on state anxiety , dysfunctional beliefs and the quantity of suicidal acts at two year follow-up . CBT can deliver clinical ly important changes in relatively few clinical sessions in real clinical setting Background Variability in  patient-reported outcomes of psychological treatments has been partly attributed to therapists – a phenomenon commonly known as therapist effects . Meta-analytic review s reveal wide variation in therapist-attributable variability in psychotherapy outcomes , with most studies reporting therapist effects in the region of 5 % to 10 % and some finding minimal to no therapist effects . However , all except one study to date have been conducted in high-intensity or mixed intervention groups ; therefore , there is scarcity of evidence on therapist effects in brief low-intensity psychological interventions . Objective To examine therapist effects in low-intensity interventions for depression and anxiety in a naturalistic setting . Data and Analysis Session-by-session data on patient-reported outcome measures were available for a cohort of 1,376 primary care psychotherapy patients treated by 38 therapists . Outcome measures included PHQ-9 ( sensitive to depression ) and GAD-7 ( sensitive to general anxiety disorder ) measures . Three-level hierarchical linear modelling was employed to estimate therapist-attributable proportion of variance in clinical outcomes . Therapist effects were evaluated using the intra-cluster correlation coefficient ( ICC ) and Bayesian empirical predictions of therapist r and om effects . Three sensitivity analyses were conducted : 1 ) using both treatment completers and non-completers ; 2 ) a sub- sample of cases with baseline scores above the conventional clinical thresholds for PHQ-9 and GAD-7 ; and 3 ) a two-level model ( using patient-level pre- and post-treatment scores nested within therapists ) . Results The ICC estimates for all outcome measures were very small , ranging between 0 % and 1.3 % , although most were statistically significant . The Bayesian empirical predictions showed that therapist r and om effects were not statistically significantly different from each other . Between patient variability explained most of the variance in outcomes . Conclusion Consistent with the only other study to date in low intensity interventions , evidence was found to suggest minimal to no therapist effects in patient-reported outcomes . This draws attention to the more prominent source of variability which is found at the between-patient level PURPOSE For depressed older primary care patients , this study aim ed to examine ( a ) characteristics associated with depression treatment preferences ; ( b ) predictors of receiving preferred treatment ; and ( c ) whether receiving preferred treatment predicted satisfaction and depression outcomes . DESIGN AND METHODS Data are from 1,602 depressed older primary care patients who participated in a multisite , r and omized clinical trial comparing  usual care to collaborative care , which offered medication and counseling for up to 12 months . Baseline assessment included demographics , depression , health information , prior depression treatment , potential barriers , and treatment preferences ( medication , counseling )  . At 12 months , services received , satisfaction , and depression outcomes were assessed . RESULTS More patients preferred  counseling  ( 57 % ) than medication ( 43 % ) . Previous experience with a treatment type was the strongest predictor of preference . In addition , medication preference was predicted by male gender and diagnosis of major depression ( vs dysthymia ) . The collaborative care model greatly improved access to preferred treatment , especially for counseling ( 74 % vs 33 % in usual care ) . Receipt of preferred treatment did not predict satisfaction or depression outcomes ; these outcomes were most strongly impacted by treatment condition . IMPLICATION S Many depressed older primary care patients desire counseling , which is infrequently available in usual primary care . Discussion of treatment preferences should include an assessment of prior treatment experiences . A collaborative care model that increases collaboration between primary care and mental health professionals can increase access to preferred treatment . If preferred treatment is not available , collaborative care still results in good satisfaction and depression outcomes Purpose There is substantial evidence to suggest that Black and minority ethnic ( BME ) patients are disproportionately detained under the Mental Health Act ( MHA ) . We examined ethnic differences in patients assessed for detention and explored the effect of ethnicity after controlling for confounders . Methods A prospect i ve study of all  MHA assessment s conducted in 1 year ( April 2009–March 2010 ) within Birmingham and Solihull Mental Health Foundation Trust , UK . Proportion of assessment s and detentions within denominator population of service users and regional population s were calculated . Multiple regression analysis was conducted to determine which variables were associated with the outcome of MHA assessment and the role of ethnicity . Results Of the 1115 assessment s , 709 led to detentions ( 63.58 % ) . BME ethnic groups were statistically more likely to be assessed and detained under the MHA as compared to Whites , both in the service user and the ethnic population estimates in Birmingham , UK . MHA detention was predicted by having a serious mental illness , the presence of risk , older age and living alone . Ethnicity was not associated with detention under the MHA with age , diagnosis , risk and level of social support accounted for . Conclusion The BME ‘ disproportionality ’ in detention rates seems to be due to higher rates of mental illness , greater risk and poorer levels of social support rather than ethnicity per se UNLABELLED The UK 's Improving Access to Psychological Therapies ( IAPT ) initiative provides evidence -based psychological interventions for mild to moderate common mental health problems in a primary care setting . Predictors of treatment response are unclear . This study examined the impact of personality disorder status on outcome in a large IAPT service . We hypothesised that the presence of probable personality disorder would adversely affect treatment response . METHOD We used a prospect i ve cohort design to study a consecutive sample of individuals ( n = 1249 ) . RESULTS Higher scores on a screening measure for personality disorder were associated with poorer outcome on measures of depression , anxiety and social functioning , and reduced recovery rates at the end of treatment . These associations were not confounded by demographic status , initial symptom severity nor number of treatment sessions . The presence of personality difficulties independently predicted reduced absolute change on all outcome measures . CONCLUSIONS The presence of co-morbid personality difficulties adversely affects treatment outcome among individuals attending for treatment in an IAPT service . There is a need to routinely assess for the presence of personality difficulties on all individuals referred to IAPT services . This information will provide important prognostic data and could lead to the provision of more effective , personalised treatment in IAPT OBJECTIVES To evaluate clinical effectiveness at 4 weeks of antidepressant therapy for mothers with postnatal depression ( PND ) compared with general supportive care ; to compare outcome at 18 weeks of those r and omised to antidepressant therapy with those r and omised to listening visits as the first intervention ( both groups were to be allowed to receive the alternative intervention after 4 weeks if the woman or her doctor so decided ) ; and to assess acceptability of antidepressants and listening visits to users and health professionals . 
    Output:
    
Conclusions We identified key predictors for recovery in a community setting s from five countries .