The management of depression in primary health care

Depression is common and disabling in primary health care. Treatment of thi s condition with simple and inexpensive approaches such as screening or phy sician education alone do not appear to produce any significant or lasting benefit. Evidence of the effectiveness of therapeutic interventions for cas es of mild severity is limited but quite encouraging for major depressive e pisodes, Both pharmacological and psychological interventions appear almost equally effective. Evidence is accumulating that, irrespective of the acti ve components of treatment, more intensive and organized treatment of depre ssion in primary health care is needed in order to improve clinical and fun ctional outcomes. However these intensive approaches are more expensive and a careful cost-benefit analysis of treatment packages and intervention com ponents is needed to guide further management decisions in this field. Curr Opin Psychiatry 12:103-107. (C) 1999 Lippincott Williams & Wilkins.