The Screening and Post-Management of Depression in Primary Care

The purpose of this review was to summarize evidence of the effectiveness of screening for depression and managing depression in primary care. Depressive disorders are common in primary care patients. Screening in primary care may help clinicians identify missed depression cases and initiate appropriate treatment. However, the evidence does not support screening alone in absence of additional staff providing case management. Based on the evidence produced by previous studies, a collaborative care team composed of a primary care physician, a depression care manager, and a psychiatrist has been proven to be an effective way of providing appropriate depression treatment for the patients in primary care. Collaborative care was effective in reducing depressive symptoms, improving adherence to antidepressant medication, preventing relapse, reducing suicidal ideation, and decreasing medical costs. Collaborative care was originally developed in the United States, and has recently been tested outside the US, such as in European and Asia-Pacific countries. The present review concluded that collaborative care was an effective depression treatment strategy, and the effectiveness of collaborative care in depression management needs to be studied in Korea as well.