Is remission of depressive symptoms in primary care a realistic goal? A meta-analysis.
BACKGROUND
A primary goal of acute treatment for depression is clinical remission of symptoms. Most meta-analyses of remission rates involve randomized controlled trials (RCTs) using patients from psychiatric settings, but most depressed patients are treated in primary care. The goal of this study was to determine remission rates obtained in RCTs of treatment interventions for Major Depressive Disorder (MDD) conducted in primary care settings.


METHODS
Potentially relevant studies were identified using computerized and manual search strategies up to May 2003. Criteria for inclusion included published RCTs with a clear definition of remission using established outcome measures.


RESULTS
A total of 13 studies (N = 3202 patients) meeting inclusion criteria were identified. Overall remission rates for active interventions ranged between 50% and 67%, compared to 32% for pill placebo conditions and 35% for usual care conditions.


CONCLUSIONS
Remission rates in primary care studies of depression are at least as high as for those in psychiatric settings. It is a realistic goal for family physicians to target remission of symptoms as an optimal outcome for treatment of depression.
Dawson
Marliese Y
MY
Division of Clinical Neuroscience, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T 2A1. mdawson@interchange.ubc.ca
Michalak
Erin E
EE
Waraich
Paul
P
Anderson
J Ellen
JE
Lam
Raymond W
RW
D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008605:Mental Health Services; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction
D000928:Antidepressive Agents