The American researchers, led by Leif I. Solberg, M.D., assert that their findings, taken over a 3-month follow-up period, emphasize the importance of education, counseling, and psychiatric referral as components of health care plans drawn up by primary care physicians.

"They [the patients] seem relatively satisfied with the courtesy and respect shown to them, but there is considerable room for improvement with satisfaction with choices of treatment, the ease of getting help, or seeking specialists and follow-up care," said Solberg.

Almost 78 percent of the 274 patients in the study received a prescription for antidepressants, and 94 percent of those prescriptions were filled. A much lower proportion of patients, roughly 33 percent, reported that they were given educational recommendations or support materials.

The patients, mostly white and female, were given a survey 1 week after their initial diagnosis of depression and 3 months afterward. The survey contained questions on doctor visits, prescriptions, other therapies, and their general health status. Investigators also compared the patients' survey answers with information in their medical records.

All patients had access to mental health counselors at their primary care clinics as well as off-site, full-time psychiatric services, and both services were available without a referral from their primary care physician. However, only half of the patients who were notified of their diagnosis reported they had received a recommendation to see a mental health professional.

In addition, few patients had multiple follow-up visits with their doctor, and many patients reported that they had stopped taking their antidepressant medication during the 3 months after diagnosis.

Although patients' average scores on depression tests improved slightly over the 3 months of therapy, their "relatively low level of satisfaction with depression care or feeling able to get the help needed for their depression remained unchanged," said Solberg.