Mental health interventions and future major depression among primary care patients with subthreshold depression

Davidson, Sandra, Harris, Meredith G., Dowrick, Christopher F., Wachtler, Caroline A., Pirkis, Jane and Gunn, Jane M. (2015) Mental health interventions and future major depression among primary care patients with subthreshold depression. Journal of Affective Disorders, 177 65-73. doi:10.1016/j.jad.2015.02.014


Author Davidson, Sandra
Harris, Meredith G.
Dowrick, Christopher F.
Wachtler, Caroline A.
Pirkis, Jane
Gunn, Jane M.
Title Mental health interventions and future major depression among primary care patients with subthreshold depression
Journal name Journal of Affective Disorders   Check publisher's open access policy
ISSN 1573-2517
0165-0327
Publication date 2015-05-15
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.jad.2015.02.014
Volume 177
Start page 65
End page 73
Total pages 9
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2016
Formatted abstract
Background

Subthreshold depression is prevalent in primary care and is associated with poorer quality of life, higher health care use and increased risk of major depressive disorder (MDD). Currently, it is unclear how subthreshold depression should be managed in primary care and no studies have investigated the relationship between current models of care and the development of MDD. This study aimed to describe usual care over a six month follow-up for primary care patients with subthreshold depression and to investigate the relationship between usual care and the development of MDD.

Methods

Data were derived from 250 participants with subthreshold depression from the diamond study, a longitudinal cohort study of primary care patients. Participants completed questionnaires at three and six months on their health care use, the interventions they received and their depression status. Interventions were categorised according to the NICE guidelines for the management of depression in adults. Generalised estimating equation (GEE) models and logistic regression were used to estimate the association between receiving an intervention and MDD over six months.

Results


Four fifths (80.8%) of participants received a mental health intervention. Therapeutic listening, reassurance, pharmacotherapy and advice to exercise were most common. Subsequent MDD was predicted by history of depression, baseline depressive symptom severity and receiving a mental health intervention.

Limitations


Usual care was assessed via patient self-report.

Conclusions


Primary care physicians deliver mental health interventions to most subthreshold patients. However, it appears that current interventions are not averting MDD. Further research to identify effective interventions which are feasible in primary care is needed.
Keyword Subthreshold depression
Major depressive disorder
Primary care
Treatment
Usual care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
 
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