Treating Major Depression in Primary Care Practice

Schulberg, Herbert C.; Block, Marian R.; Madonia, Michael J.; Scott, Chris; Rodríguez, Eric; Imber, Stanley D.; Perel, James M.; Lave, Judith R.; Houck, Patricia R.; Coulehan, John L.

doi:10.1001/archpsyc.1996.01830100061008

Cited by 382 publications

(111 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite a substantial literature on depression in the primary care setting, and strong evidence supporting the AHCPR depression treatment guidelines [43], it is possible that the information and recommendations put forth have not found their way to PCPs at large. Indeed, Feldman et al [44]surveyed 992 family physicians and found that only one third were aware of the AHCPR depression guidelines, and only 13% had a copy of the guidelines.…”

Section: Discussionmentioning

confidence: 99%

Management of Major Depression in the Primary Care Setting

Mischoulon¹,

McColl-Vuolo²,

Howarth³

et al. 2001

Psychother Psychosom

View full text Add to dashboard Cite

Background: Patients treated in community clinics, particularly those of minority status, may rely more heavily on primary care physicians (PCPs) for the diagnosis and management of depression. We wished to determine how PCPs in a community clinic setting initially manage patients newly diagnosed with major depression. Methods: 698 patients were screened for major depression by the Structural Clinical Interview for DSM-III-R in a community-based primary care health center. Forty outpatients (29 Hispanic) were found to suffer from major depression. A letter explaining positive findings was sent to the patients’ PCPs. Medical record charts were reviewed 3 months later to determine the PCP’s management following the diagnosis. Results: Of the 38 patients who remained in the study at 3 months, 20 (53%) received no intervention from the PCP by the end of 3 months after diagnosis, and of these, 14 were Hispanic. Five (13%) were prescribed an antidepressant by the PCP. Nine (24%) were referred to mental health services for medication, psychotherapy or combination treatment. Four (11%) were prescribed an antidepressant and then referred to mental health services. Differences between management of Hispanic and non-Hispanic patients were not statistically significant. Conclusions: Independent screening by psychiatrists in primary care settings may not be adequate enough to ensure appropriate management of depression by PCPs. Possible explanations may include time constraints during primary care visits, patient and/or physician reticence, and insufficient education of PCPs about depression.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of Major Depression in the Primary Care Setting

Mischoulon¹,

McColl-Vuolo²,

Howarth³

et al. 2001

Psychother Psychosom

View full text Add to dashboard Cite

show abstract

“…Unter denen, die als depressiver "Fall" erkannt wurden, erhält nur ein Bruchteil eine Behandlung, die gemäß fachlicher Leitlinien als adäquat bezeichnet werden kann. Dabei wird speziell im deutschen Sprachraum auf die vergleichsweise hohen Raten von Sedativa-Verschreibungen, sowie die im Vergleich zu trizyklischen Antidepressiva niedrigeren Verschreibungsraten an SSRIs hingewiesen [2,5,7,16].…”

Section: Schlüsselwörterunclassified

Prävalenz, Erkennens- und Verschreibungsverhalten bei depressiven Syndromen Eine bundesdeutsche Hausarztstudie

et al. 2002

View full text Add to dashboard Cite

This study examines the prevalence of depressive syndromes among unselected primary care patients as well as doctors' recognition and treatment rates. This nationwide study included a total of 20,421 patients attending their primary care doctors (n = 633) on the study's target day. Patients received a self-report questionnaire including the depression screening questionnaire (DSQ) to provide diagnoses of depressive disorders according to the criteria of DSM-IV and ICD-10. These data were compared to the doctor's evaluation form for each patient to assess the physician's diagnostic decision, assessment of clinical severity, and treatment choices. The findings confirm the high prevalence of depressive syndromes in primary care settings (11.3%) and underline the particular challenge posed by a high proportion of patients near the diagnosis threshold. Although recognition rates among more severe major depressive patients (59%) as well as treatments prescribed appear to be more favourable than in previous studies, the situation in less severe cases and the high proportion of doctors' definite depression diagnoses in patients who do not fulfill the diagnostic criteria still raise significant concerns.

show abstract

“…Numerous statistical reworkings of this landmark study have done little to change the outcome pattern (Gibbons et al, 1993;Klein & Ross, 1993). Schulberg et al (1996Schulberg et al ( , 1998 also reported a more rapid and effective outcome for IPT compared with GP treatment as usual in primary care patients with depression but found that initial severity of depression and functional ability were unrelated to clinical course.…”

Section: Evidence Basementioning

confidence: 97%

Depression

Law

2007

Handbook of Evidence‐based Psychotherapies

View full text Add to dashboard Cite

Treating Major Depression in Primary Care Practice

Cited by 382 publications

References 37 publications

Management of Major Depression in the Primary Care Setting

Management of Major Depression in the Primary Care Setting

Prävalenz, Erkennens- und Verschreibungsverhalten bei depressiven Syndromen Eine bundesdeutsche Hausarztstudie

Depression

Contact Info

Product

Resources

About