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June 16, 2004

Interventions for Treatment of Depression in Primary Care

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(23):2814. doi:10.1001/jama.291.23.2814-a

To the Editor: Dr Bruce and colleagues1 reported that, compared with usual care, presence of a depression specialist in primary care practices resulted in reduced suicidal ideation and a more favorable clinical course among elderly patients with major and minor depression. I am concerned, however, that patients in the intervention condition had access not only to a depression specialist, but to free medication and psychotherapy. The patients who received routine care had neither. Thus, it is not clear how much of the clinical effect was due to the presence of the specialist, particularly as patients in the intervention group were approximately 4 times more likely to receive any treatment than those in routine care.

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