IMPROVING THE TREATMENT OF DEPRESSION IN PRIMARY-CARE - PROBLEMS AND PROSPECTS

Previous work has succeeded in improving the recognition of depression by general practitioners. This is likely to be of most benefit when i t results in effective treatment. Factors compromising the effectivene ss of pharmacological treatments include non-compliance, non-response, and relapse of depression. Psychological therapies, such as cognitive therapy, are effective and may prevent relapse, but are not available to the majority of depressed patients seen in primary care. Existing evidence demonstrates that primary care staff can be trained in effect ive psychological interventions for depression, but interventions need to be developed which are sufficiently brief to be incorporated into routine treatment. Consistent provision of information about depressio n, coping strategies, and sources of support may improve compliance wi th treatment and subsequent outcome.