[Evaluation of the Program for Depression Detection, Diagnosis, and Comprehensive Treatment in primary care in Chile].

Autor:	Alvarado R; Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile. ralvarado@machi.med.uchile.cl, Vega J, Sanhueza G, Muñoz MG
Jazyk:	Spanish; Castilian
Zdroj:	Revista panamericana de salud publica = Pan American journal of public health [Rev Panam Salud Publica] 2005 Oct-Nov; Vol. 18 (4-5), pp. 278-86.
DOI:	10.1590/s1020-49892005000900008
Abstrakt:	Objective: To conduct a preliminary evaluation of the Program for Depression Detection, Diagnosis, and Comprehensive Treatment, which was developed by the Ministry of Health of Chile. Material and Methods: A group of women who had entered the Depression Program in eight primary care centers in three regions of Chile were monitored for three months. The initial sample was made up of 229 women, of whom 169 were able to be interviewed at the end of the three months. Sociodemographic variables, psychosocial risk factors, anxiety and somatic symptoms, and the degree of satisfaction with the care received were studied. Depressive symptoms were evaluated with the Beck Depression Inventory (BDI). The treatments prescribed for the women were also analyzed. Results: The clinicians' decision to enroll the patients in the Depression Program was appropriate, with 95.2% of the women having depressive symptoms, according to the BDI. The accuracy in the clinical assessment of the severity of the symptoms was around 50%, with a tendency to underestimate the severity of the depression. The dropout rate for the women was 19.5% at the end of three months of monitoring. Those who dropped out tended to present less severe clinical symptoms (less intense anxiety and somatic symptoms), a smaller number of psychosocial risk factors, and a lower level of satisfaction with the care received. The patients showed good adherence (73.3%) with the pharmacological treatment, but less with the individual psychotherapy (47.4%) and the group psychotherapy (37.8%). A significant decline was seen in the intensity of the depressive symptoms by the end of the three months, with the decline being greater among the women with more serious symptoms. There was also a significant decline in anxiety and somatic symptoms. Conclusions: The preliminary evaluation indicates that the Depression Program is meeting the proposed objectives, although there appears to be a need to develop specific strategies to improve the accuracy of the clinical diagnosis as well as compliance with the treatments that are offered.
Databáze:	MEDLINE
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