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October 15, 2003

Treatment of Depression by Mental Health Specialists and Primary Care Physicians

Author Affiliations

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

JAMA. 2003;290(15):1991-1993. doi:10.1001/jama.290.15.1991-a

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