A recent study in the United States has revealed that many patients suffering from depression who are high utilisers of medical services, will respond well to treatment afforded by physicians who consult closely with psychiatrists.
Of a screening sample of 100 000 patients, 10 461 were defined as high utilisers of medical services (averaging seven to eight visits to medical service providers each year). Of the high-utilisers, 14% suffered from major depression. The research study involved randomly assigning patients into a depression management program or merely informing them of their diagnosis. The depression management program made use of primary care physicians to diagnose and treat patients with antidepressants for ten weeks. After ten weeks, if there were no signs of improvement, the physician consulted with a psychiatrist – if improvement continued to be unsatisfactory, patients were referred to psychiatrists for further treatment. The program also included a co-ordinator who ensured that patients filled prescriptions and attended follow-up visits, and also made use of extensive educational material in the way of books and videos. After six months of follow-up, the proportion of patients treated in the management program who remained in remission was significantly higher than those not treated in the program.