The DOI matches its Crossref record; 65 of the 67 references it cites were found in a registry or an index.
The Depression Treatment Cascade in Primary Care: A Public Health Perspective
Open accessAbstract
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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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
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“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]
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Cites
Molecular Mechanisms of Depression: Perspectives on New Treatment Strategies
Lang, U. E., & Borgwardt, S. (2013) · Cellular Physiology and Biochemistry · doi:10.1159/000350094 · Cited by 8,526
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988
The Prevalence of Comorbid Depression in Adults With Diabetes
Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001) · Diabetes Care · doi:10.2337/diacare.24.6.1069 · Cited by 3,926
Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.629 · Cited by 2,695 · cited 2×
“They determined that 38% were receiving “minimally adequate treatment,” which they defined as pharmacotherapy for at least 2 months plus more than 4 visits to any physician; or at least 8 psychotherapy visits of 30 min or more to any provider [19].”
BackgroundMethodDepression and poor glycemic control: a meta-analytic review of the literature.
Lustman, P. J., Anderson, R. J., Freedland, K. E., de Groot, M., Carney, R. M., & Clouse, R. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.7.934 · Cited by 1,854
Association of depression and diabetes complications: a meta-analysis
de Groot, M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200107000-00015 · Cited by 1,799 · cited 1×
“Also across these conditions, depression is consistently associated with poorer engagement in chronic medical care, poorer adherence to chronic medical treatment regimens, and worse clinical outcomes [27, 58–63].”
BackgroundCollaborative care for patients with depression and chronic illnesses
Katon, W. J., Lin, E. H. B., Von Korff, M., Ciechanowski, P., Ludman, E. J., Young, B., Peterson, D., Rutter, C. M., McGregor, M., & McCulloch, D. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1003955 · Cited by 1,697
Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.10.1097 · Cited by 1,645
PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder
Gelenberg, A. J., Freeman, P. B., Markowitz, J. C., Rosenbaum, J. F., Thase, M. E., Trivedi, M. H., & Rhoads, R. S. (2010) · Cited by 1,372
Collaborative Care for Depression: A Cumulative Meta-analysis and Review of Longer-term Outcomes
Gilbody, S. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.21.2314 · Cited by 1,340
Research works printed but not linked: 2
- Mugavero MJ. Guidelines for improving HIV treatment “adherence”: The big picture. 6th International Conference on HIV Treatment and Prevention Adherence. Miami, FL 2011.
- Agency for Health Care Policy and Research. Depression in Primary Care: Vol 2: Treatment of Major Depression. Rockville: US Dept of Health and Human Services; 1993.
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Lee, M. D., & Malik, T. S. (2022) · Springer eBooks · doi:10.1007/978-3-031-11984-2_15
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Barans, S., Saavedra, J. L., Lardier, D. T., Tohen, M. F., Lenroot, R., Bustillo, J., Halperin, D., Friedman, B. R., Loewy, R. L., Murray-Krezan, C. M., et al. (2025) · Community Mental Health Journal · doi:10.1007/s10597-024-01430-z
Zahniser, J. H., & Rennebohm, W. C. (2026) · Springer eBooks · doi:10.1007/978-3-032-11264-4_2
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Mental health of people attending non-psychiatric outpatient clinics
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Metadata
- 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
- 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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