Patricia R Houck

Patricia R Houck
University of Pittsburgh | Pitt · Health Economics

MSH Biostatistics

About

343
Publications
44,100
Reads
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29,117
Citations
Additional affiliations
January 1988 - December 2013
University of Pittsburgh
Education
August 1985 - December 1987
University of PIttsburgh
Field of study
  • Biostatistics

Publications

Publications (343)
Article
Full-text available
The patient-centered medical home (PCMH) model emphasizes comprehensive, coordinated, patient-centered care, with the goals of reducing spending and improving quality. To evaluate the impact of PCMH initiatives on utilization, cost, and quality, we conducted a metaanalysis of methodologically standardized findings from evaluations of eleven major P...
Article
To determine whether an evidence-based wellness program for individuals with spina bifida (SB) and spinal cord injury (SCI) would improve health outcomes and patient experience of care, result in a positive return on investment (ROI), and provide evidence for scalability. Design: non-randomized, non-controlled cohort study; two years of enrollment...
Article
This study examines the prevalence and characteristics of services reported by school staff for 543 high school students participating in the 8 year follow-up of the multi-site Multimodal Treatment study of ADHD (MTA). Overall, 51.6% of students with a history of attention-deficit/hyperactivity disorder (ADHD) were receiving services through an Ind...
Article
To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative psychostimu...
Article
The aim of this study is to compare the Empirical Behavioral Rating Scale (E-BEHAVE-AD), Neurobehavioral Rating Scale (NBRS), and Neuropsychiatric Interview (NPI) in detecting behavioral disturbance and psychotic symptoms in dementia and characterizing changes in response to treatment. Eighty-seven subjects in the randomized controlled trial "Conti...
Article
The authors treated 115 elderly patients (ambulatory and without dementia) with recurrent major depression, by means of combined nortriptyline and interpersonal psychotherapy. They contrasted Cumulative Illness Rating Scale-Geriatric (CIRS-G) scores (for medical burden) in recovered and nonrecovered patients and generated a Cox proportional-hazards...
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Background: Childhood abuse and neglect have been linked with increased risks of adverse mental health outcomes in adulthood and may moderate or predict response to depression treatment. In a small randomized controlled trial treating depression in a diverse sample of nontreatment-seeking, pregnant, low-income women, we hypothesized that childhood...
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: Lack of feeling connected and poor social problem solving have been described in suicide attempters. However, cognitive substrates of this apparent social impairment in suicide attempters remain unknown. One possible deficit, the inability to recognize others' complex emotional states has been observed not only in disorders characterized by promi...
Article
Given the association of depression with poorer cardiac outcomes, an American Heart Association Science Advisory has advocated routine screening of cardiac patients for depression using the 2-item Patient Health Questionnaire (PHQ-2) "at a minimum." However, the prognostic value of the PHQ-2 among HF patients is unknown. We screened hospitalized HF...
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The authors quantitatively examined differences in psychiatric residents' and attending physicians' communication profiles and voice tones. Audiotaped recordings of 49 resident-patient and 35 attending-patient medication-management appointments at four ambulatory sites were analyzed with the Roter Interaction Analysis System (RIAS). Nonparametric t...
Article
Optimism has been associated with a lower risk of rehospitalization after coronary artery bypass graft (CABG) surgery, but little is known about how optimism affects treatment of depression in post-CABG patients. Using data from a collaborative care intervention trial for post-CABG depression, we conducted exploratory post hoc analyses of 284 depre...
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Identifying the predictors of late-life depression that are amenable to change may lead to interventions that result in better and faster remission. Thus, the authors investigated the impact of two different strategies for coping with physical illness on depression in older, primary care patients. Health-oriented goal engagement strategies involve...
Article
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Interpersonal and social rhythm therapy (IPSRT) is an evidence-based psychotherapy for mood disorders. The goal of this quality improvement initiative was to demonstrate feasibility of implementing IPSRT across the continuum of outpatient and inpatient care within an academic medical center. A multidisciplinary work group was convened to implement...
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To determine the nature of telephone-delivered collaborative care intervention provided to patients younger than and older than 60 years experiencing clinically significant depressive symptoms after coronary artery bypass graft (CABG) surgery and whether patient age is related to response and remission rates and delivery of care at 8-month follow-u...
Article
Full-text available
To validate the ApneaLINK (AL) as an accurate tool for determining the presence of obstructive sleep apnea (OSA) in an at-risk sleep clinic population in a home test environment. Consecutive participants referred with the suspicion of OSA were evaluated in the home with the AL portable monitor (AL Home), followed by simultaneous data collection wit...
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Background : Over 50% of patients with major depressive disorder (MDD) either do not tolerate or do not respond to antidepressant medications. Several preliminary studies have shown the benefits of acupuncture in the treatment of depression. We sought to determine whether a 2-point electroacupuncture protocol (verum acupuncture) would be beneficial...
Article
Sleep disturbance may affect smoking cessation efforts. We describe sleep changes across three months among women in a smoking cessation program and tested whether sleep disturbances at baseline and 1 month post-quit attempt predicted smoking status at three months. Participants (N=322) were women in a randomized, clinical trial for smoking cessati...
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Full-text available
Chronic insomnia is a common health problem with substantial consequences in older adults. Cognitive behavioral treatments are efficacious but not widely available. The aim of this study was to test the efficacy of brief behavioral treatment for insomnia (BBTI) vs an information control (IC) condition. A total of 79 older adults (mean age, 71.7 yea...
Article
Over 50% of patients with major depressive disorder (MDD) either do not tolerate or do not respond to antidepressant medications. Several preliminary studies have shown the benefits of acupuncture in the treatment of depression. We sought to determine whether a 2-point electroacupuncture protocol (verum acupuncture) would be beneficial for MDD, in...
Article
To examine the impact of physician counseling on perceived risks, benefits, and likelihood of use of anxiolytic pharmacotherapy during pregnancy among women with a history of anxiety. We surveyed 96 nonpregnant women, aged 21-45 years, with panic disorder and/or generalized anxiety disorder (DSM-IV criteria) recruited by their family physicians to...
Article
This study examined whether some of the age-associated decrements in basic cognitive resources (information-processing speed and working memory) result from anticholinergic medication use (as measured by serum anticholinergic activity [SAA]) and whether such decrements are lessened by caffeine. Cross-sectional observational study. University medica...
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To compare the trajectories of cognitive decline between groups with, and without, the later development of psychotic symptoms during Alzheimer disease (AD) or mild cognitive impairment (MCI). : The authors examined cognitive function in a new analysis of an existing data set, the Cardiovascular Health Study, an epidemiologic, longitudinal follow-u...
Article
Having failed to respond to an adequate antidepressant treatment course predicts poorer treatment outcomes in patients with major depression. However, little is known about the impact of prior treatment on the outcome of major depression with psychotic features (MDpsy). We examined the effect of prior treatment history on the outcome of pharmacothe...
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Full-text available
Cognitive impairment in late-life depression is a core feature of the illness. To test whether donepezil hydrochloride and antidepressant therapy is superior to placebo and antidepressant therapy in improving cognitive performance and instrumental activities of daily living and in reducing recurrences of depression over 2 years of maintenance treat...
Article
While age at onset may be useful in explaining some of the heterogeneity of bipolar disorder (BD) in large, mixed age groups, investigations to date have found few meaningful clinical differences between early versus late age at onset in older adults with BD. Data were collected from sixty-one subjects aged 60 years and older, mean (SD) age 67.6 (7...
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To compare the frequencies of risk factors, we describe risks for depression as a function of race among consecutively admitted participants in a randomized clinical trial of indicated depression prevention in later life. Seventy-two black and 143 white participants were screened for risk factors for depression. Black participants were more likely...
Article
More than half of the older adults respond only partially to first-line antidepressant pharmacotherapy. Our objective was to test the hypothesis that a depression-specific psychotherapy, Interpersonal Psychotherapy (IPT), when used adjunctively with escitalopram, would lead to a higher rate of remission and faster resolution of symptoms in partial...
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The majority of women who quit smoking as a result of pregnancy will resume smoking during the first 6 months postpartum. Evidence suggests that changes in depressive symptoms, perceived stress, and concerns about weight may relate to postpartum smoking relapse. This study was designed to prospectively evaluate the relationship of mood and weight c...
Article
To describe the relationship between pain and depression on recovery after coronary artery bypass grafting (CABG). A secondary data analysis on 453 depressed and nondepressed post-CABG patients enrolled in a randomized, controlled, effectiveness trial of telephone-delivered collaborative care for depression. Outcome measures were collected from Mar...
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This article describes patterns of concordance/discordance between self-reported abilities ("can do") and habits ("does do") and observed task performance of daily living tasks in three groups of older adults: late life depression with mild cognitive impairment (n=53), late life depression without mild cognitive impairment (n=64), and non-depressed...
Article
Sensitivity to psychotropic medications presents a therapeutic challenge when treating neuropsychiatric symptoms in patients with dementia with Lewy bodies (DLB). We compared under randomized, double-blinded conditions the tolerability and efficacy of citalopram and risperidone in the treatment of behavioral and psychotic symptoms in patients with...
Article
Although interpersonal psychotherapy (IPT) is an efficacious treatment for acute depression, the relative efficacy of treatment in each of the four IPT problem areas (grief, role transitions, role disputes, interpersonal deficits) has received little attention. We evaluated the specificity of IPT by comparing treatment success among patients whose...
Article
More than half of older adults with major depressive disorder require extended treatment because of incomplete response during acute treatment. This study characterizes the effect of anxiety on remission during extended treatment for partial responders. Following 6 weeks of escitalopram 10 mg/day+depression care management (DCM), 124 partial respon...
Article
Chengappa KNR, Turkin SR, Schlicht PJ, Murphy SL, Brar JS, Fagiolini A, Houck PR, Garbutt RG, Fredrick N. A Pilot, 15-month, randomised effectiveness trial of Risperidone long acting injection (RLAI) versus oral atypical antipsychotic agents (AAP) in persons with bipolar disorder. Objective: Long-acting injectible antipsychotic agents are rarely co...
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Although many studies suggest that, on average, depression-specific psychotherapy and antidepressant pharmacotherapy are efficacious, we know relatively little about which patients are more likely to respond to one versus the other. We sought to determine whether measures of spectrum psychopathology are useful in deciding which patients with unipol...
Article
We examined the utility of the Affective States Questionnaire (ASQ) in predicting acute risk for suicidal behavior. Subjects at a VHA Medical Center were interviewed using the ASQ and again 3 months later when their suicidal behaviors over that period were examined. The ASQ had a sensitivity of 60% for predicting suicidal behavior over the follow-u...
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Full-text available
Background We previously documented that cognitive behavioral therapy for smoking-related weight concerns (CONCERNS) improves cessation rates. However, the efficacy of combining CONCERNS with cessation medication is unknown. We sought to determine if the combination of CONCERNS and bupropion therapy would enhance abstinence for weight-concerned wo...
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This study sought to document self-reported binge eating in a large sample of severely obese children and to examine the impact of binge eating on changes in percent overweight among children randomized to family-based behavioral treatment (intervention) versus control (usual care). As part of a larger randomized controlled trial, 192 children aged...
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The risk/benefit ratio of pharmacotherapy for behavioral symptoms of dementia is questionable: second-generation antipsychotics are poorly tolerated, and the efficacy of alternative treatments, for example, selective serotonin-reuptake inhibitors (SSRIs), is uncertain. Biomarkers of treatment response may improve this risk/benefit ratio. The length...
Article
More than 5 million central venous catheters (CVCs) are placed each year, which results in more than 200 000 nosocomial blood stream infections. Many of these infections are attributed to improper placement or substandard care of the CVC. Limiting the number of infections with proper training will improve a child’s quality of life and outcome. Chil...
Article
Depression, loss, and physical illness are associated with suicide in the elderly. However, the nature of individual vulnerability remains poorly understood. Poor problem solving has been suggested as a risk factor for suicide in younger adults. Unresolved problems may create an accumulation of stressors. Thus, those with perceived deficits in prob...
Article
To determine in healthy people aged > or = 75 years 1) if restricting time in bed and education in health sleep practices are superior to an attention-only control condition (i.e., education in healthy dietary practices) for maintaining or enhancing sleep continuity and depth over 2.5 years; and 2) if maintenance or enhancement of sleep continuity...
Article
Full-text available
Social networks may protect depressed elders against suicidal behavior. However, conflict in important relationships may undermine the sense of social support, potentially negating the protective effects. Thus, we investigated the role of chronic interpersonal difficulties and perceived social support in depressed elders with and without suicidal t...
Article
Full-text available
Depressive symptoms commonly follow coronary artery bypass graft (CABG) surgery and are associated with less positive clinical outcomes. To test the effectiveness of telephone-delivered collaborative care for post-CABG depression vs usual physician care. Single-blind effectiveness trial at 7 university-based and community hospitals in or near Pitts...
Article
Cognitive impairment in bipolar disorder has been associated with poor functional outcomes. We examined the relation of self-reported cognitive problems to employment trajectory in patients diagnosed with bipolar I disorder. 154 bipolar I disorder patients were followed for 15-43months at the Bipolar Disorders Center for Pennsylvanians. Using a mul...
Article
Full-text available
We evaluated the efficacy of family-based, behavioral weight control in the management of severe pediatric obesity. Participants were 192 children 8.0 to 12.0 years of age (mean +/- SD: 10.2 +/- 1.2 years). The average BMI percentile for age and gender was 99.18 (SD: 0.72). Families were assigned randomly to the intervention or usual care. Assessme...
Article
Despite ample evidence of excess cardiovascular mortality in bipolar disorder (BD), few studies have demonstrated increased prevalence of cardiovascular disease (CVD) and/or hypertension (HTN) in BD. We therefore examined this topic in a representative epidemiologic sample. The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditio...
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Full-text available
Adolescents, elderly persons, African Americans, and rural residents with bipolar disorder are less likely than their middle-aged, white, urban counterparts to be diagnosed, receive adequate treatment, remain in treatment once identified, and have positive outcomes. The Bipolar Disorder Center for Pennsylvanians (BDCP) study was designed to address...
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The authors assessed the association between public and private religious participation and depression as well as hopelessness in older depressed, adults treated in mental health settings. Data from 130 participants from a posttreatment longitudinal follow-up study of late-life depression were analyzed. Multiple regression analyses were performed t...
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We developed models of Specialized Care for Bipolar Disorder (SCBD) and a psychosocial treatment [Enhanced Clinical Intervention (ECI)] that is delivered in combination with SCBD. We investigated whether SCBD and ECI + SCBD are able to improve outcomes and reduce health disparities for young and elderly individuals, African Americans, and rural res...
Article
The authors sought to assess the longitudinal course of youths with bipolar spectrum disorders over a 4-year period. At total of 413 youths (ages 7-17 years) with bipolar I disorder (N=244), bipolar II disorder (N=28), and bipolar disorder not otherwise specified (N=141) were enrolled in the study. Symptoms were ascertained retrospectively on avera...