Major depression and its correlates in primary care settings in six countries. 9-month follow-up study.
BACKGROUND
Few published studies address depression outcomes in primary care from a cross-cultural perspective.


OBJECTIVE
To define baseline factors associated with 9-month clinical outcomes across six countries.


METHODS
Adults meeting criteria for current major depression were recruited from primary care clinics in Australia, Brazil, Israel, Spain, Russia and the USA; 968 patients were assessed at the 9-month follow-up. Predictors of complete remission were examined using logistic regression with a hierarchical model.


RESULTS
Rates of complete remission in the six sites ranged from 25% to 48%. Logistic regression using pooled data showed that education, key life events and the Quality of Life Depression Scale score at baseline were the final predictors of complete remission, adjusting for centres, socio-demographic data, severity of depression, comorbidity and general quality of life. Variationin predictors across sites was not statistically significant.


CONCLUSIONS
The two major findings of this study were the low proportion of people achieving complete remission at follow-up across the six sites, and that some baseline characteristics (education, Quality of Life Depression Scale score and key life events) are modest predictors of outcome in depression.
De Almeida Fleck
Marcelo Pio
MP
Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil. mfleck.voy@zaz.com.br
Simon
Gregory
G
Herrman
Helen
H
Bushnell
Donald
D
Martin
Mona
M
Patrick
Donald
D
D001315:Australia; D001938:Brazil; D003431:Cross-Cultural Comparison; D003863:Depression / Q000175:diagnosis* / Q000628:therapy; D004522:Educational Status; D006801:Humans; D007557:Israel; D008016:Life Change Events; D016015:Logistic Models; D008137:Longitudinal Studies; D011320:Primary Health Care; D011379:Prognosis; D011788:Quality of Life; D012426:Russia; D013030:Spain; D016896:Treatment Outcome; D014481:United States