title: ['Optimal care for depression': Freiburg model of integrated care for depressive disorders].
abstract: BACKGROUND
  Health care for persons with depressive disorders is not networked to an optimal degree in Germany. In order to improve outpatient care, an integrated care model for patients with depressive disorders was initiated in Freiburg in December 2008. The model aims at implementation of central recommendations of the "Conceptual Framework Integrated Care: Depression" of the German Association for Psychiatry and Psychotherapy.
  
  
  METHODS
  Usage of health services and effects of the model were analyzed by means of patient and physician data as part of a continuous project evaluation.
  
  
  RESULTS
  Since the launch of the project in December 2008, 40 physicians have been participating, and have included a total of 234 patients. Unipolar depressions constitute by far the most frequent disorders (91%). Most patients showed moderate (58%) or severe (36%) depressive symptoms. Most disorders were recurrent (61%). About three quarters of patients (75%) are treated exclusively by general practitioners. According to the physicians' ratings, 58% of the patients were remitted or showed subsyndromal symptoms in the eighth treatment week following their inclusion in the Freiburg model. After 16 weeks this number rose to 70% of patients. According to the information provided by the patients, in the PHQ-D, 59% of the patients were remitted or showed minimal symptoms.
  
  
  CONCLUSIONS
  In the Freiburg model the "Conceptual Framework Integrated Care: Depression" could be implemented under current routine conditions. The first evaluation results indicate the success of this model. The results are indicative of a high quality of health care of the Freiburg model.
authors.affiliation: Abt. Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg.
authors.forename: Isaac
authors.initials: I
authors.lastname: Bermejo
authors.forename: Lars P
authors.initials: LP
authors.lastname: Hölzel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Voderholzer
authors.forename: Ludger Tebartz
authors.initials: LT
authors.lastname: van Elst
authors.forename: Mathias
authors.initials: M
authors.lastname: Berger
mesh_terms: D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D019983:Guideline Adherence; D006284:Health Plan Implementation / Q000458:organization & administration; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D009462:Neurology; D010348:Patient Care Team / Q000458:organization & administration*; D015397:Program Evaluation; D011570:Psychiatry; D011613:Psychotherapy; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012017:Referral and Consultation / Q000458:organization & administration; D013557:Switzerland; D016896:Treatment Outcome