TELEPHONE COUNSELING FOR PATIENTS WITH MINOR DEPRESSION - PRELIMINARYFINDINGS IN A FAMILY-PRACTICE SETTING

BACKGROUND. Depression is a frequently occurring condition in family p ractice patients, but time limitations may hamper the physician's abil ity to it treat effectively. Referrals to mental health professionals are frequently resisted by patients. The need for more effective treat ment strategies led to the development and evaluation of a telephone-b ased, problem-solving intervention. METHODS. Patients in a family prac tice residency practice were evaluated through the Medical Outcomes St udy Depression Screening Scale and the Diagnostic interview Schedule t o identify those with subthreshold or minor depression. Twenty-nine su bjects were randomly assigned to either a treatment or comparison grou p. initial scores on the Hamilton Depression Rating Scale were equival ent for the groups and were in the mildly depressed range. Six problem -solving therapy sessions were conducted over the telephone by graduat e student therapists supervised by a psychiatrist. RESULTS. Treatment group subjects had significantly lower post-intervention scores on the Hamilton Depression Rating Scale compared with their pre-intervention scores (P < .05). Scores did not differ significantly over time in th e comparison group. Post-intervention, treatment group subjects also h ad lower Beck Depression Inventory scores than did the comparison grou p (P < .02), as well as more positive scores for social health (P < .0 02), mental health (P < .05), and self-esteem (P < .05) on the Duke He alth Profile. CONCLUSIONS. The findings indicate that brief, telephone -based treatment for minor depression in family practice settings may be an efficient and effective method to decrease symptoms of depressio n and improve functioning. Nurses in these settings with appropriate t raining and supervision may also be able to provide this treatment.