Pharmacological and psychosocial treatment of depression in primary care : Low intensity and poor adherence and continuity

Show simple item record Vuorilehto, Maria S. Melartin, Tarja K. Riihimaki, Kirsi Isometsa, Erkki T. 2017-09-20T21:05:05Z 2021-12-17T18:49:42Z 2016-09-15
dc.identifier.citation Vuorilehto , M S , Melartin , T K , Riihimaki , K & Isometsa , E T 2016 , ' Pharmacological and psychosocial treatment of depression in primary care : Low intensity and poor adherence and continuity ' , Journal of Affective Disorders , vol. 202 , pp. 145-152 .
dc.identifier.other PURE: 68761940
dc.identifier.other PURE UUID: 554afd55-9a85-47a0-bb93-1d78296f819b
dc.identifier.other WOS: 000380555400021
dc.identifier.other Scopus: 84989925712
dc.description.abstract Background: Primary health care bears the main responsibility for treating depression in most countries. However, few studies have comprehensively investigated provision of pharmacological and psychosocial treatments, their continuity, or patient attitudes and adherence to treatment in primary care. Methods: In the Vantaa Primary Care Depression Study, 1111 consecutive primary care patients in the City of Vantaa, Finland, were screened for depression with Prime-MD, and 137 were diagnosed with DSM-IV depressive disorders via SCID-I/P and SCID-Il interviews. The 100 patients with current major depressive disorder (MDD) or partly remitted MDD at baseline were prospectively followed up to 18 months, and their treatment contacts and the treatments provided were longitudinally followed. Results: The median number of patients' visits to a general practitioner during the follow-up was five; of those due to depression two. Antidepressant treatment was offered to 82% of patients, but only 50% commenced treatment and adhered to it adequately. Psychosocial support was offered to 49%, but only 29% adhered to the highly variable interventions. Attributed reasons for poor adherence varied, including negative attitude, side effects, practical obstacles, or no perceived need. About one-quarter (23%) of patients were referred to specialized care at some time-point. Limitations: Moderate sample size. Data collected in 2002-2004. Conclusions: The majority of depressive patients in primary health care had been offered pharmacotherapy, psychotherapeutic support, or both. However, effectiveness of these efforts may have been limited by lack of systematic follow-up and poor adherence to both pharmacotherapy and psychosocial treatment. (C) 2016 Elsevier B.V. All rights reserved. en
dc.format.extent 8
dc.language.iso eng
dc.relation.ispartof Journal of Affective Disorders
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Primary care
dc.subject Depression
dc.subject Treatment
dc.subject Adherence
dc.subject Follow-up
dc.subject Outcome
dc.subject Antidepressants
dc.subject Psychosocial support
dc.subject RISK-FACTORS
dc.subject DSM-IV
dc.subject 3124 Neurology and psychiatry
dc.subject 3112 Neurosciences
dc.title Pharmacological and psychosocial treatment of depression in primary care : Low intensity and poor adherence and continuity en
dc.type Article
dc.contributor.organization Clinicum
dc.contributor.organization Department of Psychiatry
dc.contributor.organization HUS Psychiatry
dc.description.reviewstatus Peer reviewed
dc.relation.issn 0165-0327
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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