Predictors of response to problem-solving treatment of depression in primary care

Problem-solving treatment of depression is a brief intervention specifically designed for primary care (PST-PC). To date, predictors of an optimal response to PST-PC have not been studied. In primary care, knowing such factors is essential for proper triage decisions. Patient, therapist, and process variables were evaluated for their ability to predict remission of minor depression or dysthymia in patients treated with PST PC. The most salient predictors of remission were the ability to understand the PST-PC rationale and to apply the PST-PC procedure in early treatment sessions, having a cognitive-behavioral therapist, and, for dysthymia, having a lower depression severity level at baseline. These results provide preliminary evidence of some factors associated with an optimal response to PST-PC and also present challenges for the ability to broadly disseminate the intervention. Modifications to the existing PST PC training program and directions for future research are discussed.