Background. Few data are available regarding the impact
improved depression treatment on daily functioning and disability.
Methods. In two studies of more intensive depression treatment
in primary care, patients initiating
antidepressant treatment were randomly assigned to either usual care or
to a collaborative
management programme including patient education, on-site mental health
of antidepressant medication, behavioural activation and monitoring of
Assessments at baseline as well as 4 and 7 months included
several measures of impairment, daily
functioning and disability[ratio ]self-rated overall health, number of
bodily pains, number of somatization
symptoms, changes in work due to health, reduction in leisure activities
due to health, number of
disability days and number of restricted activity days.
Results. Average data from the 4- and 7-month assessments in
both studies, intervention patients
reported fewer somatic symptoms (OR 0·68, 95% CI 0·46, 0·99)
and more favourable overall health
(OR 0·50, 95% CI 0·28, 0·91). While intervention patients
fared better on other measures of
functional impairment and disability, none of these differences
reached statistical significance.
Conclusions. More effective acute-phase depression treatment
reduced somatic distress and
improved self-rated overall health. The absence of a significant intervention
effect on other disability
measures may reflect the brief treatment and follow-up period and the
influence of other individual and environmental factors on disability.