What do psychiatrists talk about with their depressed patients parallel to prescribing an antidepressant?

BACKGROUND: Treatment of depression includes pharmacotherapy as well as psychotherapy. Even if no specific psychotherapy is done, still, pharmacotherapy must be accompanied by patient education, reassurance and guidance. There is a lack of data available on the content of psychiatrist-patient interactions additional to prescribing an antidepressant.
METHOD: A total of 43 psychiatrists in ambulatory practice treated 200 depressed outpatients for 12 weeks with the antidepressant mirtazapine. Content of the patient-psychiatrist interaction was assessed by the pivotal topic method.
RESULTS: Patient-psychiatrist encounters lasted on average 17.5 min (SD = 6.9 min). Primary topics were at the beginning of treatment the therapeutic alliance, assessment of symptoms, patient education, and discussion of problems in life; after 2 weeks of medication compliance; after 8 weeks progress of illness and increase of activities; and after 12 weeks progress and relapse prevention. Limitations. Only patients who were treated with an antidepressant were included, so that results may be different in other cases.
CONCLUSION: The primary content of conversation is case management, supportive reassurance and alliance building while specific pychotherapeutic interventions are the exception. The content of psychiatrist-patient verbal interaction depends on time of treatment. The data describe "psychiatric counselling and psychotherapy" in routine care as opposed to "specific psychotherapy".