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

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

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

DOI 10.1007/s11920-012-0274-yPMC PMC3410049

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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.

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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.
ORCID: Pence, Brian W.
O’Donnell, Julie K.
Gaynes, Bradley N.
Venue: Current Psychiatry Reports
Publisher: Springer Science and Business Media LLC
Published: 2012-05-13
Volume: 14
Issue: 4
Pages: 328-335
ISSN: 1523-3812 (ISSN-L)
1535-1645
DOI: 10.1007/s11920-012-0274-y
PMC: PMC3410049
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: green
europepmc.org
Licence: www.springer.com/tdm (tdm)
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: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Pharmacology (medical) › 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

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

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