Study on treating depression sheds light on how to get best care

If you think you might be suffering from depression or if someone (say a spouse) thinks you might, then going to your primary health care professional is an excellent starting place for your recovery. You should note however that according to a recent RAND study, once the diagnosis was made primary care physicians were found deficient in adhering to recommended practices for treating depression.

The study, which was published in the September 4 edition of the Annals of Internal Medicine (press release here), found that:

... most primary care physicians did a good job of diagnosing and beginning treatment for depression, with guidelines aimed at these issues followed more than 70 percent of the time. These guidelines includes items such as talking to patients about depression and closely monitoring patients newly placed on antidepressant medication.

But researchers found that primary care clinicians did less well following up with treatment over time. Fewer than half of the patients in the study completed the minimal course of treatment for either antidepressant drugs or psychotherapy, and only slightly more than half the depressed patients who were not treated were monitored closely.

The lowest quality of care occurred among the patients who exhibited the most serious symptoms, including patients who showed evidence of suicide or substance abuse. For example, among patients who had a previous suicide attempt, just 35 percent were referred to a mental health specialist over the next six months.

This is important because the study also (not surprisingly) found that patients who received better-quality care reported fewer symptoms of depression up to two years after treatment.

In short, by all means start off with your primary care physician--especially if you have a relationship with them. But once they confirm a diagnosis of depression understand that on the whole they might not provide best practices care for treating your depression. To get these you would likely need to seek out higher quality mental health care.