title: Major depression and its correlates in primary care settings in six countries. 9-month follow-up study.
abstract: 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.
authors.affiliation: Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil. mfleck.voy@zaz.com.br
authors.forename: Marcelo Pio
authors.initials: MP
authors.lastname: De Almeida Fleck
authors.forename: Gregory
authors.initials: G
authors.lastname: Simon
authors.forename: Helen
authors.initials: H
authors.lastname: Herrman
authors.forename: Donald
authors.initials: D
authors.lastname: Bushnell
authors.forename: Mona
authors.initials: M
authors.lastname: Martin
authors.forename: Donald
authors.initials: D
authors.lastname: Patrick
mesh_terms: 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