Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: Dr Dietrich and colleagues and Dr
Ebell note that patients with depression in the primary care setting are much
less likely than those in the specialty care setting to accept a diagnosis
of depression and to comply with treatment regimens. We agree that this difference
may be an important factor in the lower rate of adequacy of treatment among
primary care patients than specialty sector patients with depression. It is
apparently not an overwhelming factor, however, as a number of trials have
found that detection and treatment of depression in primary care can be improved
significantly by implementing cost-effective disease management programs.1,2
Kessler RC, Demler O, Jin R, et al. Treatment of Depression by Mental Health Specialists and Primary Care Physicians. JAMA. 2003;290(15):1991–1993. doi:10.1001/jama.290.15.1991-a
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