Treatment for Depression in the Primary Care Setting

This study will compare a brief form of counseling to usual care for the treatment of minor depression in the primary care setting.

Minor depression is one of the most common types of depressive disorders seen in primary care. The effectiveness and tolerability of antidepressants in patients with minor depression is unclear, and the development of alternative treatments is necessary. In the first phase of this study, participants are observed for 4 weeks to identify those most in need of depression-specific treatment. Participants are then exposed to the Problem-Solving Treatment for Primary Care (PST-PC), a six-session behavioral treatment for depression. After 4 weeks, patients who do not respond adequately to the treatment are randomly assigned to either continued PST-PC or to usual care for 9 weeks. Participants are followed for 6 months after the study.

Inclusion Criteria: Primary care patient at Dartmouth-Hitchcock Medical Center (DHMC) Hamilton Depression Score >= 10 and minor depression at time of entry and after 4 weeks of observation Exclusion Criteria: Psychosis, Obsessive Compulsive Disorder (OCD), or Post Traumatic Stress Disorder (PTSD) Active substance abuse Receiving treatment for depression