title: Depression in primary care: Strategies for a psychiatry-scarce environment.
abstract: More than an algorithm to guide primary care providers through treatment options, integrated care, also called collaborative care, is a validated, systematic, multidisciplinary approach to depression treatment in primary care. Historically, integrated care emerged in response to a mismatch between a growing demand for mental health treatment and scarce mental healthcare resources. Working together, psychiatrists and primary care providers have demonstrated that the principles and tools of chronic disease management improve depression outcomes in primary care. Currently, most antidepressants are prescribed by primary care providers, but with disappointing rates of full, sustained remission. Primary care patients may derive the greatest benefit from existing depression treatment guidelines when they are melded with an approach informed by integrated care principles. This paper will present established guidelines for pharmacologic management of depression as part of a broader framework for depression treatment in the primary care office.
authors.affiliation: University of Virginia School of Medicine, Charlottesville, VA, USA aa3u@virginia.edu.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Alson
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Robinson
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Ivanova
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Azer
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Moreno
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: Marie Lyse
authors.initials: ML
authors.lastname: Turk
authors.affiliation: University of Virginia Health System, VA, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Nitturkar
authors.affiliation: Michigan State University, MI, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Blackman
mesh_terms: D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D011320:Primary Health Care / Q000592:standards*
keywords: depression treatment; integrated care; major depressive disorder; primary care