Cited by 133Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The Depression Treatment Cascade in Primary Care: A Public Health Perspective

Open access
Pence, Brian W., O’Donnell, Julie K., Gaynes, Bradley N.·2012·Current Psychiatry Reports

Abstract

Major depressive disorder (MDD) is common and costly. Primary care remains a major access point for depression treatment, yet the successful clinical resolution of depression in primary care is uncommon. The clinical response to depression suffers from a "treatment cascade": the affected individual must access health care, be recognized clinically, initiate treatment, receive adequate treatment, and respond to treatment. Major gaps currently exist in primary care at each step along this treatment continuum. We estimate that 12.5% of primary care patients have had MDD in the past year; of those with MDD, 47% are recognized clinically, 24% receive any treatment, 9% receive adequate treatment, and 6% achieve remission. Simulations suggest that only by targeting multiple steps along the depression treatment continuum (e.g. routine screening combined with collaborative care models to support initiation and maintenance of evidence-based depression treatment) can overall remission rates for primary care patients be substantially improved.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s11920-012-0274-y

Cites

65 of 65 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Only about 5-7% of persons with depression treated in primary care settings would be expected to achieve remission.

    “Hence, only about 5-­ 7% of persons with de­ pres­ sion treated in primary care settings would be expected to achieve remission 106 .”

    From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [106]

    The Depression Treatment Cascade > Summary estimates that 6% of all primary care patients with past-year depression achieve remission, consistent with the quoted 5–7%. But the claim describes the denominator as persons treated in primary care; the same passage says only 24% of depressed primary care patients receive any treatment. The 6% estimate is not a remission rate among treated patients. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • Approximately 10-15% of patients in primary care present with clinically significant depressive symptoms, and only about half of these cases are diagnosed, of which an estimated 25% are prescribed an antidepressant.

    “Approximately 10-­ 15% of patients in primary care present with clinically significant depressive symptoms, and only about half of these cases are diagnosed, of which an estimated 25% are prescribed an antidepressant 106 .”

    From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [106]

    The Prevalence and Summary sections estimate past-year major depressive disorder in 12.5% of primary-care patients and clinical recognition in 47% of those patients, supporting the first two approximations. The Summary estimates that 50% of clinically recognized cases receive any treatment, or 24% of all patients with MDD; it does not say that 25% of diagnosed cases are prescribed an antidepressant. No page numbers are provided in our copy. (LLM, conf=0.91)

    Experimental — accuracy not yet measured
  • Replicated evidence indicates that, of those prescribed antidepressants, the majority discontinue treatment prematurely.

    “Replicated evidence indicates that, of those prescribed antidepressants, the majority discontinue treatment prematurely.”

    From Treatment‐resistant depression: definition, prevalence, detection, management, and investigational interventions (2023) · cites this paper as [106]

    The ‘Adequacy of treatment’ section reports that many people receiving mental health treatment do not receive adequate care, but it does not say that a majority of those prescribed antidepressants discontinue them prematurely. Searches for antidepressant discontinuation and adherence found no passage establishing that claim; the reference-list mention of treatment discontinuations gives no rate. (LLM, conf=0.73)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

2 of the 67 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [13]Mugavero MJ Guidelines for improving HIV treatment “adherence”: The big picture 6th International Conference on HIV Treatment and Prevention Adherence Miami, FL 2011

Cited by

Sorted by citations

Authors
Pence, B. W., O’Donnell, J. K., & Gaynes, B. N.
Affiliations
  • Duke University (US)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Pence, Brian W.
Venue
Current Psychiatry Reports
Published
2012-05-13
Volume
14
Issue
4
Pages
328-335
ISSN
  • 1523-3812 (ISSN-L)
  • 1535-1645
OpenAlex
W2151955213
Cited by
133
References
67
Citations by year
2026: 9 · 2025: 7 · 2024: 8 · 2023: 15 · 2022: 10 · 2021: 10 · 2020: 12 · 2019: 12 · 2018: 10 · 2017: 9 · 2016: 14 · 2015: 6 · 2014: 4 · 2013: 7
FWCI
0.77
Type
journal article
Language
en
Open access
Locations
  • Current Psychiatry Reports (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
  • UNC Libraries
Funders
  • U.S. Department of Veterans Affairs (R25 MH080916-01A2)
  • Bristol-Myers Squibb
  • Washington University in St. Louis (R25 MH080916-01A2)
  • National Institutes of Health
  • Agency for Healthcare Research and Quality
  • Quality Enhancement Research Initiative (R25 MH080916-01A2)
  • Arts and Humanities Research Council
  • National Institute of Mental Health (MH080916, R01MH086362, R25MH080916)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
major depressive disorder, primary care, depression screening, collaborative care, depression remission, treatment gap, public health approach, depression prevalence
MeSH terms
Continuity of Patient Care, Major Depressive Disorder, Humans, Primary Health Care, Public Health, United States, Prevalence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review