Recorded presentation

Joanna Volpe-Vartanian, MS, LICSW, Schneider Institute for Health Policy, Heller School for Social Policy and Management, Brandeis University, MS 35,415 South St, Waltham, MA 02454, (617) 734-5108, jvolpevartanian@aol.com, Dominic Hodgkin, PhD, Schneider Institute for Health Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, and Margarita Alegria, PhD, Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon Street, 4th Floor, Somerville, MA 02143.

Many individuals with alcohol and depression disorders do not recognize these problems, and their disorders are not detected by their medical providers, reducing likelihood of timely treatment. There are also known differences between men and women in their recognition of alcohol problems and depression. How might managed care influence patients’ problem recognition? Plans may act in ways that encourage recognition (e.g. promoting screening) or discourage it (e.g. shortening medical visits). This study: (1) compares patterns of problem recognition for alcohol and depression, 2) examines male-female differences in problem recognition, and 3) asks whether managed care has altered those patterns. This study uses interview data collected in three waves on a random community sample of adults living in low-income areas of Puerto Rico; managed care was implemented across regions in stages. Respondents' depression and alcohol dependence or abuse was assessed using standardized diagnostic instruments: Center Epidemiological Studies - Depression Scale (CES-D) and Composite International Diagnostic Interview (CIDI). Data collection began in 1992, before managed care’s introduction, and continued until 1998, when two-thirds of islanders were enrolled in carve-outs. Preliminary findings suggest: 1) about half of men and women recognize their depression, and 10-14% of men and women not meeting diagnostic criteria report having a problem, 2) alcohol problems are far less recognized by both genders; of those meeting diagnostic criteria, more women than men recognize a problem, and 3) managed care did not alter the patterns of problem recognition. Implications include: improving screening strategies and increasing public awareness of these disorders.

Learning Objectives: Attendees will be able to

• understand patterns of problem recognition for alcohol and depression, including male-female differences in problem recognition,
• evaluate managed care's potential to influence these patterns, 3)become familiar with the standardized diagnostic instruments used (CES-D) and (CIDI), and 4)discuss better screening strategies and improved prevention efforts targeted to alcohol and depressive disorders.

Keywords: Alcohol Problems, Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation