Managing depression in primary care

doi:10.1136/bmj.322.7289.746

BMJ 2001;322:746-747 ( 31 March )

Editorials

Managing depression in primary care

The type of treatment matters less than ensuring it is done properly and followed up

Primary care p 772

The first 150 words of the full text of this article appear below.

Several recent studies have evaluated alternative approaches to managing depression in primary care. The range of diseaseand the treatments examined have varied widely, no doubt contributingto the variation in results. Nevertheless, randomised trials leavelittle doubt that antidepressant drugs are efficacious in majordepression, ¹ ² and recent evidence suggests efficacy in dysthymiaand subsyndromal depression as well.³ But what role does counsellingplay in the primary care management of patients with various formsof depression? Recent trials in primary care have produced conflictingresults andconclusions.

The paper in this issue by Chilvers et al (p 772)⁴ and an earlier report from the same study⁵ address three importantquestions about treating major depression in primary care. Isthere a difference in the effectiveness of drugs versus counselling?Is the non-standardised counselling provided by most mental healthproviders effective? Does matching treatment with patient preferencesincrease effectiveness? In Chilvers . . . [Full text of this article]

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Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms: Clair Chilvers, Michael Dewey, Katherine Fielding, Virginia Gretton, Paul Miller, Ben Palmer, David Weller, Richard Churchill, Idris Williams, Navjot Bedi, Conor Duggan, Alan Lee, and Glynn Harrison
BMJ 2001 322: 772. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Solberg, L. I., Trangle, M. A., Wineman, A. P. (2005). Follow-Up and Follow-Through of Depressed Patients in Primary Care: The Critical Missing Components of Quality Care. J Am Board Fam Med 18: 520-527 [Abstract] [Full text]
Dowrick, C. (2005). In this issue. Chronic Illness 1: 95-96
Thomas, C. M., Morris, S. (2003). Cost of depression among adults in England in 2000. Br. J. Psychiatry 183: 514-519 [Abstract] [Full text]

Rapid Responses:

Read all Rapid Responses

Which treatment can a PHS afford?: Regina Stroebele
bmj.com, 1 Apr 2001 [Full text]
The type of treatment matters less than ensuring it is done properly and followed up: David Simpson
bmj.com, 7 Apr 2001 [Full text]