title: Enhanced care for depression.
abstract: OBJECTIVE
  The purpose of this study is to review recent evidence of the effects of enhanced depression care, focusing (1) on symptomatic, functional and economic outcomes and (2) across different countries, (3) ethnic groups and (4) settings.
  
  
  RESULTS
  Collaborative care is currently by far the most influential and best studied method to enhance depression care. Recent trials and reviews provide firm evidence that collaborative care is more effective than care as usual (CAU), though with small effects. These effects generalized across several important health outcomes are probably more pronounced in patients with more complex or severe disorders. Cost-effectiveness and cost utility data demonstrate that collaborative care is of good value for money, and this is probably more pronounced in patients with higher a-priori levels of healthcare utilization. Collaborative care is readily exported to other healthcare systems, other regions of the world and other cultures.
  
  
  CONCLUSIONS
  Given parallel development and successful testing of other cheaper and more simple interventions targeting depression (such as guided self-help and e-mental health), it may be that collaborative care will focus on the more severe, complex or recurrent forms of affective disorder in the future. Including effects of collaborative care on other outcomes, especially on work-related functioning and economic productivity, seems fruitful.
authors.affiliation: VUmc University Medical Center, Amsterdam, the Netherlands. a.beekman@ggzingeest.nl
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: Christina
authors.initials: C
authors.lastname: van der Feltz-Cornelis
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
mesh_terms: D019090:Case Management / Q000458:organization & administration*; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D003866:Depressive Disorder / Q000628:therapy*; D014943:Global Health; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D011787:Quality of Health Care / Q000592:standards*