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VOLUME 54 | NUMBER 3 | JUNE 2019


Individual and neighborhood characteristics as predictors of depression symptom response

Objective: Assess whether neighborhood characteristics predict patientreported outcomes for depression.

Data Sources: VA electronic medical record data and U.S. census data.

Study Design: Retrospective longitudinal cohort.

Data Extraction Methods: Neighborhood and individual characteristics of patients (N = 4,269) with a unipolar depressive disorder diagnosis and an initial Patient Health Questionnaire (PHQ9) score ≥10 were used to predict 50 percent improvement in 48month PHQ9 scores.

Principal Findings: The proportion of a patient's neighborhood living in poverty (OR = 0.98; 95% CI: 0.97.1.00; P = 0.03) was associated with lower likelihood of depression symptom improvement in addition to whether the patient was black (OR = 0.76; 95% CI:0.610.96; P = 0.02) had PTSD (OR = 0.59; 95% CI:0.500.69; P < 0.001) or had any serviceconnected disability (OR = 0.73; 95% CI:0.610.87; P < 0.001).

Conclusions: Neighborhood poverty should be considered along with patient characteristics when determining likelihood of depression improvement.

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