Sheehan disability scale as outcome measure in depressed out-patients

Abstract

Dutch mental health care system to collaborate with primary care. This study evaluates the effectiveness of a collaborative care program (CCP) in a primary care setting for unselected common mental disorders compared to traditional referral to a primary or secondary mental health organisation (Care As Usual; CAU). Methods: In a cluster randomised controlled trial, 27 GPs were assigned to either CCP or CAU. The CCP condition refers to brief interventions with a maximum of 5 appointments in the GPs' office and, if indicated, followed by referral to specialised mental health care. The study included 165 patients. At baseline and after 3, 6 and 12 months, psychopathology and quality of life were assessed. Patients' and GPs' appreciation of mental health care and the number of mental health care appointments were assessed after 3, 6 and 12 months. The data were analysed with hierarchical linear models. Results: Patients' mean symptom score and quality of life significantly improved over time, with no significant differences between conditions. There was no significant difference in appreciation of mental health care between patients of both conditions. The CCP condition resulted in a significantly higher appreciation by GPs, significantly shorter waiting time, less number of appointments and shorter duration of treatment compared to CAU. Discussion: Collaborative care for patients with unselected common mental disorders seems to be as effective as CAU. However, the CCP condition was (much) more cost effective and collaborative care is also more appreciated by the GPs.