[How can the results of primary-care treatment for depression be improved?].
BACKGROUND
The results of treatment for depression are frequently disappointing. The main reasons for this are inadequate treatment and non-compliance.


OBJECTIVE
This article attempts to deal with the question of how patient compliance and the results of treatment for depression can be improved.


METHODS
We performed a critical analysis of the literature. We searched Medline (1966- January 2002), psycinfo (1984-January 2002), Embase (1980-January 20002) and the Cochrane Controlled Trials Register (1966-Janaury 2002) for reports of randomised controlled trials. In our search we used the terms 'patient compliance', 'adherence', patient dropout', 'depression', 'depressive disorder', and 'affective disorder'. On the basis of the results of our search we compared two interventions that could be applied in Dutch practices. results We found 11 articles, all relating to treatment in primary care settings. Usual care proved to be inadequate. The quality of the usual care currently provided can be improved by extra interventions. So far there are no indications that complex interventions benefit the patient more than simple interventions, such as regular follow-up procedures. Therefore, for the time being, simple interventions are to be preferred.


CONCLUSIONS
Treatment for depression can be improved by means of relatively simple interventions.
Vergouwen
A C M
AC
Sint Lucas Andreas Ziekenhuisin Amsterdam. a.vergouwen@slaz.nl
Burger
H
H
Verheij
T J M
TJ
Koerselman
G F
GF
D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy / Q000628:therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D010349:Patient Compliance; D010821:Physicians, Family / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D016032:Randomized Controlled Trials as Topic; D017211:Treatment Failure
D000928:Antidepressive Agents