Can depression be managed appropriately in primary care?

This review considers the necessary conditions for appropriate management of depression in primary care. While discussion of primary care management has often focused on the recognition of depression, recognition alone is not sufficient. Recent research demonstrates that primary care management of depression frequently fails to meet recommended standards for intensity of treatment and follow-up. Several recent randomized trials show that effective treatment of depression in primary care is possible but will require significant changes in current practice. Prerequisites for more effective management of depression in primary care include appropriate patient education, systematic monitoring of care processes and outcomes, and easy access to the full range of psychiatric consultation services.