Care utilization and outcome of DSM-III-R major depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Objective: To assess care utilization, individual characteristics and clinical and functional outcomes for various modalities of professional care in people with DSM-III-R major depression. Method: Psychiatric diagnoses were determined at baseline and 12-month follow-up in a representative sample (N = 7076) of the Dutch population, using the Composite International Diagnostic Interview (CIDI). Results: A total of 45.3% of the 223 individuals with major depression received professional care in the 12 months between baseline and followup, and 42.6% of these were treated with antidepressant medication. Higher level of care was associated with clinical factors and functional limitations. Clinical outcomes were poorly correlated with functional outcomes. Mild to moderate effects in functional outcome were found for all care modalities. Conclusion: Outcome of antidepressant treatment can be improved and such treatment should focus on the more severe forms of depression. Functional outcome assessment is recommended in addition to clinical assessment.