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Ongoing primary care intervention increased remission and emotional and physical role functioning in major depression

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QUESTION: In patients with major depression, is ongoing intervention (augmented care management) more effective than usual care for increasing remission and emotional and physical role functioning?


Cluster randomised (allocation concealed), blinded (data collectors), controlled trial with 24 months of follow up.


12 primary care practices (8 in metropolitan and 4 in non-metropolitan areas) in the US.


211 patients (mean age 43 y, 85% women) with major depression (defined as reporting ≥5 of 9 criteria for major depression listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition revised) who where identified after screening during routine visits to primary care practices. Exclusion criteria included bereavement, mania, alcohol dependence, pregnancy or postpartum period, or life threatening physical illness. Patients …

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  • Sources of funding: National Institute of Mental Health and the John D and Catherine T MacArthur Foundation.

  • For correspondence: Dr K Rost, Department of Family Medicine, University of Colorado Health Sciences Center at Fitzsimons, Aurora, CO, USA.Kathryn.Rost{at}