community-based. Evidence from primary care settings suggests that models of care that integrate multiple interventions (e.g., education, care management, frequent telephone follow-up) are clinically effective in reducing depressive symptoms in adults. Existing studies are relatively short term, however, and the cost-effectiveness and exportability of these models are not usually considered.

  • Studies of approaches to effectively deliver treatment and to prevent relapse in adults with depression rarely target parents, especially in settings in which traditionally underserved populations of parents or their children are seen.

  • Treatments that address individual patient preferences, concurrent conditions (such as medical comorbidities and substance abuse), overcoming depression-related stigma and mistrust, and health disparities tend to be better received and more effective than approaches that rely on health provider experience alone.

Depression is a common and recurrent disorder that can have profound effects on medical, social, and financial well-being, and a large body of literature documents safe and effective therapeutic strategies. In this chapter, we have divided these strategies into treatments (i.e., tools) and interventions (i.e., approaches). Standard treatments for depression include pharmacotherapy, psychotherapy and alternative remedies. Successful interventions have generally been more structured and comprehensive, often featuring multidisciplinary approaches that emphasize several treatment modalities (e.g., collaborative care).

Although the evidence base is rich for depression treatments and interventions in the general adult population, far fewer studies have analyzed outcomes in parents or families. For this reason, we have chosen to proceed in this chapter with a brief summary of treatment rates, therapeutic options, and interventions in the general adult population before focusing more intently on the body of literature specific to parents. Chapter 7 addresses the approaches to prevent adverse outcomes in depressed parents and the children of depressed parents, including the impact of treatment on families.

The committee reviewed the relevant literature in order to identify depression treatment rates, therapeutic options that are available to treat depression, and options for the delivery of depression treatment in the general adult population that address outcomes for depressed adults and then specifically in parents, as well as to identify areas in which relatively little research has been conducted. The committee did not seek to systematically



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