Care utilization and outcome of DSM-III-R major depression in the general population. Results from the Netherlands Mental Health Survey and IncidenceStudy (NEMESIS)

Objective: To assess care utilization, individual characteristics and clini cal and functional outcomes for various modalities of professional care in people with DSM-III-R major depression. Method: Psychiatric diagnoses were determined at baseline and 12-month foll ow-up in a representative sample (N = 7076) of the Dutch population, using the Composite International Diagnostic Interview (CIDI). Results: A total of 45.3% of the 223 individuals with major depression rece ived professional care in the 12 months between baseline and followup, and 42.6% of these were treated with antidepressant medication. Higher level of care was associated with clinical factors and functional limitations. Clin ical outcomes were poorly correlated with functional outcomes. Mild to mode rate effects in functional outcome were found for all care modalities. Conclusion: Outcome of antidepressant treatment can be improved and such tr eatment should focus on the more severe forms of depression. Functional out come assessment is recommended in addition to clinical assessment.