Rf. Munoz et al., ON THE AHCPR DEPRESSION IN PRIMARY-CARE GUIDELINES - FURTHER CONSIDERATIONS FOR PRACTITIONERS, The American psychologist, 49(1), 1994, pp. 42-61
The majority of cases of clinical depression go unrecognized and untre
ated, despite the fact that depression is an eminently treatable disor
der. The Agency for Health Care Policy and Research (AHCPR) recently p
ublished a set of clinical practice guidelines focused on depression i
n primary care settings. The review of the literature on which the gui
delines are based is thorough and appropriate and should enhance the d
etection of depression and the quality of pharmacotherapy for depressi
on. However, the guidelines encourage primary care physicians to provi
de pharmacotherapy To their depressed patients as the first line of tr
eatment. The wisdom of this recommendation is questioned and revisions
to the guidelines are suggested. Specifically, patients should be inf
ormed of the broad array of treatment options available and provided w
ith a more balanced presentation of the potential benefits of psychoth
erapy for depression. Patients should decide which treatment alternati
ve they wish to undergo.