The Importance of Efficient Depression Management in Primary Care

Christos G. Theleritis; Thomas J. Paparrigopoulos; George N. Papadimitriou

doi:10.7326/0003-4819-148-7-200804010-00018

Letters |1 April 2008

The Importance of Efficient Depression Management in Primary Care

Christos G. Theleritis, MD; Thomas J. Paparrigopoulos, MD; George N. Papadimitriou, MD

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TO THE EDITOR:

In their recent article, Hepner and colleagues (1) mention that depression rarely leads to death. This is astonishing, because patients with major depression have an increased overall relative risk for death (1.81 [95% CI, 1.58 to 2.07]) compared with people without depression (2). Even for subclinical depression, this risk is no smaller than the relative risk associated with clinical depression (2). A large part of the increased mortality in depression is due to the risk for suicide (4 to 16 times higher than that in persons without depression) (3).

In this context, we consider the results of Hepner and colleagues' study to be alarming. Complex interventions that combine clinician education, an enhanced management role for the nurse, a better integration between primary and secondary care, and telephone medication counseling by trained clinicians might help considerably in improving depression management in the primary care setting (1, 4). On the other hand, simple educational strategies and the mere implementation of treatment guidelines might not be so effective (4, 5).

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2008 American College of Physicians

Letters |1 April 2008

The Importance of Efficient Depression Management in Primary Care

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Letters |1 April 2008

The Importance of Efficient Depression Management in Primary Care

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