Antidepressant drugs are the most prevalent, and often the only, treatment offered to patients newly diagnosed with depression, even when mental health therapy is readily available, according to a new study.

And after three months of treatment, many depressed patients have relatively low satisfaction with their care, say Leif I. Solberg, M.D., of HealthPartners Research Foundation and colleagues.

"They seem relatively satisfied with the courtesy and respect shown to them, but there is considerable room for improvement with satisfaction with choices of treatment, the ease of getting help or seeking specialists and follow-up care," Solberg says.

Almost 78 percent of the patients in the study received a prescription for antidepressants, and 94 percent of these prescriptions were filled. But only a third of the patients reported receiving educational recommendations or materials.

The researchers surveyed 274 patients, mostly white and female, a week after their initial diagnosis of depression and three months later, asking them about their doctor visits, prescriptions, other therapies and their general health status. Solberg and colleagues also compared the patients' survey answers to their medical charts.

All patients had access to mental health counselors at their primary care clinics as well as off-site, full-time mental health services, both available without a referral from their doctor. However, only half of the patients who were notified of their diagnosis say they received a recommendation to see a mental health therapist.

Few of the patients had multiple follow-up visits to their doctor, and many patients stopped taking their antidepressants during the three months after their diagnosis, according to the researchers.

Although patients' average scores on depression tests improved slightly over the three months of therapy, their "relatively low level of satisfaction with depression care or feeling able to get the help needed for their depression remained unchanged," says Solberg.

The study is published in the February 2003 issue of The American Journal of Managed Care and was supported by the MacArthur Foundation Initiative on Depression and Primary Care.

~Becky Ham

---Health Behavior News Service

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