Patient education and group counselling to improve the treatment of depression in primary care: a randomized controlled trial.
BACKGROUND
The Contactus program for depressed patients in primary care, consists of six lectures about depression, each followed by a group discussion. The aim of this study was to investigate if Contactus can improve treatment outcome in comparison to a control group.


METHODS
Forty-six primary care centres in Sweden, each randomly allocated either to the Contactus group or to the control group, included depressed patients, 205 in the Contactus group and 114 in the control group. Besides regular treatment of depression, the Contactus group participated in the educational program. At start and after 6 weeks, patients filled in a questionnaire and the self-reports: HADS (Hospital Anxiety and Depression Scale) and GAF-self (Global Assessment of Functioning).


RESULTS
After 6 weeks, clinically depressed patients (HAD-depression score >10) had a mean improvement in HAD-D of 4.6 in Contactus vs. 3.0 in controls (p=0.02), and 72% vs. 47% considered themselves to feel better (p=0.01). Increase in GAF score was 11.8 vs. 5.8 (p=0.04), respectively. According to HADS, 55% in Contactus were responders vs. 29% among controls (p=0.006), and 42% vs. 21% (p=0.02) were in remission.


CONCLUSIONS
Only 40% of the patients in Contactus and 35% among controls were clinically depressed according to the HADS (>10 points) at inclusion.


CONCLUSIONS
Patient education and group counselling contributes significantly to better improvement among depressed patients. Group treatment is inexpensive and could be implemented in the routine care of depressed patients in primary care.
Hansson
Maja
M
Division of Psychiatry, Department of Clinical Sciences, University of Umeå, 901 87 Umeå, Sweden. maja.hansson@psychiat.umu.se
Bodlund
Owe
O
Chotai
Jayanti
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling / Q000379:methods*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D011795:Surveys and Questionnaires