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    Phone-Based Therapy Helps Depressed Patients

    Dial-Up Counseling Could Reach Those Who Aren't Being Treated

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    A total of 59% of patients who got psychotherapy in addition to antidepressant medications reported being "very satisfied" with their depression treatment, compared with just 29% of those who received telephone calls about their medications.

    None of the patients in the study originally sought psychotherapy, indicating that the telephone-based psychotherapy approach can reach patients who don't see themselves as candidates for counseling, Simon says.

    "With this approach we don't require that people commit to being in psychotherapy," he says. "We don't even require that they say they are depressed."

    More Study Needed

    The study's main message, Simon says, is that mental health professionals need to be more aggressive in reaching out to less-motivated patients. The research team plans to conduct further studies comparing the telephone-treatment approach with office-based psychotherapy.

    "We never had anyone say, 'Stop calling, you're bothering me,'" he says. "But many people did tell us how thankful they were that we didn't give up and stop calling."

    American Psychiatric Association spokesman Darrel A. Regier, MD, MPH, says better patient follow-up is an increasing focus of depression treatment. The APA is currently conducting a pilot study designed to improve monitoring of patients starting antidepressants. Regier says this is being done because so many patients abandon drug therapy, either because they don't feel the medications are working or because of side effects.

    Regier calls the telephone-treatment approach intriguing, but says it might be difficult to implement in the current health care environment. He points out that a third of the patients approached by Simon and colleagues refused to participate, indicating that a large percentage of depressed people would not consent to psychotherapy, no matter how it is delivered.

    Furthermore, Regier says that it is not clear if the treatment approach can work outside of a managed care setting.

    "Will patients agree to pay for this service," he says. "That is certainly not clear. Before we even try to develop a business model for this treatment we have to make sure that it works."

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