Treating depression: the beyondblue guidelines for treating depression in primary care. "Not so much what you do but that you keep doing it".
1. Most people with depression will be treated in general practice, either by the GP alone, or (for more serious depression) in partnership with specialist mental health services. 2. Treatment plans should always be based on thorough assessment, including the type, severity and duration of the depressive episode, and any stressors that contributed to the episode. 3. For mild and moderate depression, meta-analysis shows there is little difference in relative effectiveness of treatments, and continuation of therapy is more important than initial treatment choice. 4. The best outcomes are likely when a good therapeutic alliance is formed between a healthcare professional and the patient, and adequate treatment is provided over a long enough period. For pharmacological interventions, treatment should continue for: at least one year for a first episode of depression, and at least two years for repeated episodes or where there are other risk factors for relapse.
Ellis
Pete M
PM
Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, New Zealand. ellis@wnmeds.ac.nz
Smith
Don A R
DA
D003866:Depressive Disorder / Q000628:therapy*; D006801:Humans; D011320:Primary Health Care