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2012, Número 1

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Salud Mental 2012; 35 (1)


Enfocando la depresión como problema de salud pública en México

Wagner FA, González-Forteza C, Sánchez-García S, García-Peña C, Gallo JJ

Idioma: Español
Referencias bibliográficas: 130
Paginas: 3-11
Archivo PDF: 126.87 Kb.


RESUMEN

El objetivo de la presente revisión es analizar la magnitud y el impacto social de la depresión, así como explorar modelos que permitan comprender mejor las estrategias necesarias para su atención. Los reportes revelan que 9.2% de la población general ha padecido un episodio de depresión, que una de cada cinco personas sufrirá uno antes de llegar a los 75 años y que los más jóvenes presentan tasas mayores. Tasas más bajas se observan en países de ingreso bajo y medio, en contraste con países de ingreso alto. Diferencias no relacionadas con la gravedad o el retraso en el diagnóstico probablemente se vinculen con diferencias culturales. Las mujeres, las personas sin pareja y el bajo nivel de educación se asocian con mayor riesgo. El efecto deletéreo en productividad (media de 27 días perdidos en el último año) es indiscutible. La asociación con diabetes, hipertensión y trastornos cardiacos, entre otras, ha sido frecuentemente investigada. Si bien no es clara la presencia o no de factores de riesgo comunes y la cadena de causalidad, la combinación de trastornos físicos y mentales genera más discapacidad. La depresión ha sido asociada a otras conductas como adicciones, suicidio y violencia, particularmente en jóvenes. En cuanto a los efectos en el sistema de salud, diversos estudios han demostrado que los pacientes con depresión tienen mayores tasas de utilización y mayores costos asociados, particularmente con ancianos. Esta sobreutilización está relacionada con la baja proporción de diagnóstico y tratamiento certero. El 26% de las personas no serán diagnosticadas y, a pesar de que una elevada proporción de pacientes contactaron con los servicios de salud, cerca del 30% nunca recibió ayuda. Nuevos modelos de atención que incluyan el abatimiento de las barreras, el entendimiento de los factores socioculturales y la inclusión del manejo primario de la depresión son urgentes.


REFERENCIAS (EN ESTE ARTÍCULO)

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  2. Robins LN, Wing J, Wittchen HU et al. The Composite International Diagnostic Interview: An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 1988; 45:1069-1077.

  3. Kessler RC, Ustun TB. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004;13:93-121.

  4. World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research; 1993.

  5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (4a ed.). APA; 1994.

  6. Kessler RC, Angermeyer M, Anthony JC, De Graaf R et al. Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 2007;6(3):168-176.

  7. Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I et al. WHO World Mental Health Survey Consortium. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004; 291(21):2581-2590.

  8. Slone LB, Norris FH, Murphy AD, Baker CK et al. Epidemiology of major depression in four cities in Mexico. Depress Anxiety 2006; 23(3):158-167.

  9. Medina-Mora ME, Borges G, Benjet C, Lara C, Berglund P. Psychiatric disorders in Mexico: Lifetime prevalence in a nationally representative sample. Br J Psychiatry 2007; 190:521-528.

  10. Benjet C, Borges G, Medina-Mora ME, Zambrano J et al. Youth mental health in a populous city of the developing world: Results from the Mexican Adolescent Mental Health Survey. J Child Psychol Psychiatry 2009;50(4):386-395.

  11. Seedat S, Scott KM, Angermeyer MC, Berglund P et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 2009; 66(7):785-795.

  12. Bromet E, Andrade LH, Hwang I, Sampson NA et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 2011; 26; 9(1) En prensa. PMID: 21791035.

  13. Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV et al. The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12(1):3-21.

  14. Ormel J, Petukhova M, Chatterji S, Aguilar-Gaxiola S et al. Disability and treatment of specific mental and physical disorders across the world. Br J Psychiatry 2008; 192(5):368-375.

  15. Burvill PW. Recent progress in the epidemiology of major depression. Epidemiol Rev 1995; 17:21-31.

  16. Carney RM, Freedland KE, Jaffe AS. Depression as a risk factor for coronary heart disease mortality. Arch Gen Psychiatry 2001; 58:229–230.

  17. Lett HS, Blumenthal JA, Babyak MA et al. Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosom Med 2004; 66:305–315.

  18. Ormel J, Von Korff M, Burger H, Scott K et al. Mental disorders among persons with heart disease - results from World Mental Health surveys. Gen Hosp Psychiatry 2007; 29(4):325-334.

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  20. Scott KM, Von Korff M, Alonso J, Angermeyer MC et al. Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys. Psychol Med 2009; 39(1):33-43.

  21. Castillo-Quan JI, Barrera-Buenfil DJ, Pérez-Osorio JM, Alvarez-Cervera FJ. Depression and diabetes: From epidemiology to neurobiology. Rev Neurol 2010; 51(6):347-359.

  22. Reséndiz-Figueroa FE, Ortiz-Garrido OM, Pulido D, Arcila-Martínez D et al. Impacto de los rasgos de ansiedad y depresión sobre aspectos clínicos y calidad de vida en pacientes con síndrome de intestino irritable. Rev Gastroenterol Mex 2008; 73(1):3-10.

  23. Sartorius N, Üstün TB, Lecrubier Y, Wittchen HU. Depression comorbid with anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care. Br J Psychiatry 1996; 168(supl)30:38-43.

  24. Borges G, Nock MK, Medina-Mora ME, Hwang I et al. Psychiatric disorders, comorbidity, and suicidality in Mexico. J Affect Disord 2010; 124(1-2):98-107.

  25. Téllez L, Galindo O, Álvarez MA, González-Forteza C et al. Ansiedad y depresión en pacientes con cáncer testicular en tratamiento y seguimiento; una revisión. Gaceta Mexicana Oncología 2011; 10(3):129-135.

  26. Téllez-Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res 2002; 33(1):53-60.

  27. Lerman I, Lozano L, Villa AR, Hernández-Jiménez S et al. Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City. Biomed Pharmacother 2004; 58(10):566-570.

  28. Fisher L, Chesla CA, Mullan JT, Skaff MM et al. Contributors to depression in Latino and European-American patients with type 2 diabetes. Diabetes Care 2001; 24(10):1751-1757.

  29. González-Forteza C, Arana D, Jiménez A. Problemática suicida en adolescentes y el contexto escolar: Vinculación autogestiva con los servicios de salud mental. Salud Mental 2008; 31(1): 23-27.

  30. Roth KB, Borges G, Medina-Mora ME, Orozco R et al. Depressed mood and antisocial behavior problems as correlates for suicide-related behaviors in Mexico. J Psychiatr Res 2011; 45(5):596-602. Epub 2010 Nov 4.

  31. Illescas-Rico R, Amaya-Ayala F, Jiménez-López JL, Caballero-Méndez ME et al. Increased incidence of anxiety and depression during bone marrow transplantation. Arch Med Res. 2002; 33(2):144-147.

  32. Norris FH, Murphy AD, Baker CK, Perilla JL. Severity, timing, and duration of reactions to trauma in the population: an example from Mexico. Biol Psychiatry 2003; 53(9):769-778.

  33. Morales-Jaimes R, Salazar-Martínez E, Flores-Villegas FJ, Bochicchio-Riccardelli T et al. The role of depression in the quality of life among patients undergoing renal substitutive therapy. Gac Med Mex 2008; 144(2):91-98.

  34. Castilla-Puentes RC, Secin R, Grau A, Galeno R et al. A multicenter study of major depressive disorder among emergency department patients in Latin-American countries. Depress Anxiety 2008; 25(12):E199-204.

  35. Fernald LC, Jones-Smith JC, Ozer EJ, Neufeld LM et al. Maternal depressive symptoms and physical activity in very low-income children. J Dev Behav Pediatr 2008; 29(5):385-393.

  36. Simon G, Ormel J, VonKorff M, Barlow W. Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry 1995; 152(3):352-357.

  37. García-Peña C, Wagner F, Sánchez-García S, Juárez-Cedillo T et al. Depressive symptoms among older adults in Mexico City. J Gen Intern Med 2008; 12: 1973-1980.

  38. Borges G, Medina-Mora ME, Wang PS, Lara C et al. Treatment and adequacy of treatment of mental disorders among respondents to the Mexico National Comorbidity Survey. Am J Psychiatry 2006; 163(8):1371-1378.

  39. Gater R, Almeida e Sousa D, Barrientos G, Caraveo J et al. The pathways to psychiatric care: A cross-cultural study. Psychol Med 1991; 21:761-774.

  40. Borges G, Wang PS, Medina-Mora ME, Lara C et al. Delay of first treatment of mental and substance use disorders in Mexico. Am J Public Health 2007; 97(9):1638-1643.

  41. Borges G, Benjet C, Medina-Mora M, Orozco R et al. Treatment of mental disorders for adolescents in Mexico City. Bull World Health Organ 2008; 86(10):757-764.

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  43. Goldberg D, Huxley P. Common mental disorders. A bio-social model. London: Tavistock/Routledge; 1992.

  44. Goldberg D. Epidemiology of mental disorders in primary care settings. Epidemiol Rev 1995; 17:182-190.

  45. Alonso J, Buron A, Bruffaerts R, He Y et al. World Mental Health Consortium. Association of perceived stigma and mood and anxiety disor ders: Results from the World Mental Health Surveys. Acta Psychiatr Scand 2008; 118(4):305-314.

  46. Weller SC, Baer RD, Garcia de Alba Garcia J, Salcedo Rocha AL. Susto and nervios: Expressions for stress and depression. Cult Med Psychiatry 2008; 32(3):406-420.

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  55. Bogner HR, Dahlberg B, de Vries HF, Cahill E et al. Older patients’ views on the relationship between depression and heart disease. Fam Med 2008;40(9):652-657.

  56. Bogner HR, Richie MB, de Vries HF, Morales KH et al. Depression, cognition, apolipoprotein e genotype: Latent class approach to identifying subtype. American J of Geriatric Psychiatry 2009; 17:344-352.

  57. Joo JH, Wittink M, Dahlberg B. Shared Conceptualizations and Divergent Experiences of Counseling Among African American and White Older Adults. Qual Health Res 2011;21(8):1065-1074.

  58. Wittink MN, Dahlberg B, Biruk C, Barg FK. How older adults combine medical and experiential notions of depression? Qualitative Health Research 2008;18(9):1174-1183.

  59. Wiittink MN, Joo JH, Lewis LM, Barg FK. Losing faith and using faith: Older African Americans discuss spirituality, religious activities and depression. J Gen Intern Med 2009; 24(3):402-407.

  60. Moreno P, Saravanan Y, Levav I, Kohn R et al. Evaluation of the PAHO/ WHO training program on the detection and treatment of depression for primary care nurses in Panama. Acta Psychiatr Scand 2003; 108(1):61-65.

  61. Gilbody S, Bower P, Fletcher J, Richards D et al. Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med 2006; 166(21):2314-2321.

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  63. Katon WJ, Schoenbaum M, Fan MY, Callahan CM et al. Cost-effectiveness of improving primary care treatment of late-life depression. Arch Gen Psychiatry 2005; 62(12):1313-1320.

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  73. Slone LB, Norris FH, Murphy AD, Baker CK et al. Epidemiology of major depression in four cities in Mexico. Depress Anxiety 2006; 23(3):158-167.

  74. Medina-Mora ME, Borges G, Benjet C, Lara C, Berglund P. Psychiatric disorders in Mexico: Lifetime prevalence in a nationally representative sample. Br J Psychiatry 2007; 190:521-528.

  75. Benjet C, Borges G, Medina-Mora ME, Zambrano J et al. Youth mental health in a populous city of the developing world: Results from the Mexican Adolescent Mental Health Survey. J Child Psychol Psychiatry 2009;50(4):386-395.

  76. Seedat S, Scott KM, Angermeyer MC, Berglund P et al. Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 2009; 66(7):785-795.

  77. Bromet E, Andrade LH, Hwang I, Sampson NA et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 2011; 26; 9(1) En prensa. PMID: 21791035.

  78. Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV et al. The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res 2003; 12(1):3-21.

  79. Ormel J, Petukhova M, Chatterji S, Aguilar-Gaxiola S et al. Disability and treatment of specific mental and physical disorders across the world. Br J Psychiatry 2008; 192(5):368-375.

  80. Burvill PW. Recent progress in the epidemiology of major depression. Epidemiol Rev 1995; 17:21-31.

  81. Carney RM, Freedland KE, Jaffe AS. Depression as a risk factor for coronary heart disease mortality. Arch Gen Psychiatry 2001; 58:229–230.

  82. Lett HS, Blumenthal JA, Babyak MA et al. Depression as a risk factor for coronary artery disease: Evidence, mechanisms, and treatment. Psychosom Med 2004; 66:305–315.

  83. Ormel J, Von Korff M, Burger H, Scott K et al. Mental disorders among persons with heart disease-results from World Mental Health surveys. Gen Hosp Psychiatry 2007; 29(4):325-334.

  84. O’Neil A, Williams ED, Stevenson CE, Oldenburg B et al. Co-morbid cardiovascular disease and depression: sequence of disease onset is linked to mental but not physical self-rated health. Results from a crosssectional, population-based study. Soc Psychiatry Psychiatr Epidemiol 2011 Aug 10. [Epub ahead of print].

  85. Scott KM, Von Korff M, Alonso J, Angermeyer MC et al. Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys. Psychol Med 2009; 39(1):33-43.

  86. Castillo-Quan JI, Barrera-Buenfil DJ, Pérez-Osorio JM, Alvarez-Cervera FJ. Depression and diabetes: From epidemiology to neurobiology. Rev Neurol 2010; 51(6):347-359.

  87. Reséndiz-Figueroa FE, Ortiz-Garrido OM, Pulido D, Arcila-Martínez D et al. Impacto de los rasgos de ansiedad y depresión sobre aspectos clínicos y calidad de vida en pacientes con síndrome de intestino irritable. Rev Gastroenterol Mex 2008; 73(1):3-10.

  88. Sartorius N, Üstün TB, Lecrubier Y, Wittchen HU. Depression comorbid with anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care. Br J Psychiatry 1996; 168(supl)30:38-43.

  89. Borges G, Nock MK, Medina-Mora ME, Hwang I et al. Psychiatric disorders, comorbidity, and suicidality in Mexico. J Affect Disord 2010; 124(1-2):98-107.

  90. Téllez L, Galindo O, Álvarez MA, González-Forteza C et al. Ansiedad y depresión en pacientes con cáncer testicular en tratamiento y seguimiento; una revisión. Gaceta Mexicana Oncología 2011; 10(3):129-135.

  91. Téllez-Zenteno JF, Cardiel MH. Risk factors associated with depression in patients with type 2 diabetes mellitus. Arch Med Res 2002; 33(1):53-60.

  92. Lerman I, Lozano L, Villa AR, Hernández-Jiménez S et al. Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City. Biomed Pharmacother 2004; 58(10):566-570.

  93. Fisher L, Chesla CA, Mullan JT, Skaff MM et al. Contributors to depression in Latino and European-American patients with type 2 diabetes. Diabetes Care 2001; 24(10):1751-1757.

  94. González-Forteza C, Arana D, Jiménez A. Problemática suicida en adolescentes y el contexto escolar: Vinculación autogestiva con los servicios de salud mental. Salud Mental 2008; 31(1): 23-27.

  95. Roth KB, Borges G, Medina-Mora ME, Orozco R et al. Depressed mood and antisocial behavior problems as correlates for suicide-related behaviors in Mexico. J Psychiatr Res 2011; 45(5):596-602. Epub 2010 Nov 4.

  96. Illescas-Rico R, Amaya-Ayala F, Jiménez-López JL, Caballero-Méndez ME et al. Increased incidence of anxiety and depression during bone marrow transplantation. Arch Med Res. 2002; 33(2):144-147.

  97. Norris FH, Murphy AD, Baker CK, Perilla JL. Severity, timing, and duration of reactions to trauma in the population: an example from Mexico. Biol Psychiatry 2003; 53(9):769-778.

  98. Morales-Jaimes R, Salazar-Martínez E, Flores-Villegas FJ, Bochicchio-Riccardelli T et al. The role of depression in the quality of life among patients undergoing renal substitutive therapy. Gac Med Mex 2008; 144(2):91-98.

  99. Castilla-Puentes RC, Secin R, Grau A, Galeno R et al. A multicenter study of major depressive disorder among emergency department patients in Latin-American countries. Depress Anxiety 2008; 25(12):E199-204.

  100. Fernald LC, Jones-Smith JC, Ozer EJ, Neufeld LM et al. Maternal depressive symptoms and physical activity in very low-income children. J Dev Behav Pediatr 2008; 29(5):385-393.

  101. Simon G, Ormel J, VonKorff M, Barlow W. Health care costs associated with depressive and anxiety disorders in primary care. Am J Psychiatry 1995; 152(3):352-357.

  102. García-Peña C, Wagner F, Sánchez-García S, Juárez-Cedillo T et al. Depressive symptoms among older adults in Mexico City. J Gen Intern Med 2008; 12: 1973-1980.

  103. Borges G, Medina-Mora ME, Wang PS, Lara C et al. Treatment and adequacy of treatment of mental disorders among respondents to the Mexico National Comorbidity Survey. Am J Psychiatry 2006; 163(8):1371-1378.

  104. Gater R, Almeida e Sousa D, Barrientos G, Caraveo J et al. The pathways to psychiatric care: A cross-cultural study. Psychol Med 1991; 21:761-774.

  105. Borges G, Wang PS, Medina-Mora ME, Lara C et al. Delay of first treatment of mental and substance use disorders in Mexico. Am J Public Health 2007; 97(9):1638-1643.

  106. Borges G, Benjet C, Medina-Mora M, Orozco R et al. Treatment of mental disorders for adolescents in Mexico City. Bull World Health Organ 2008; 86(10):757-764.

  107. Goldberg D, Huxley P. Mental illness in the community: The pathway to psychiatric care. London: Tavistock Publications; 1980.

  108. Goldberg D, Huxley P. Common mental disorders. A bio-social model. London: Tavistock/Routledge; 1992.

  109. Goldberg D. Epidemiology of mental disorders in primary care settings. Epidemiol Rev 1995; 17:182-190.

  110. Alonso J, Buron A, Bruffaerts R, He Y et al. World Mental Health Consortium. Association of perceived stigma and mood and anxiety disor ders: Results from the World Mental Health Surveys. Acta Psychiatr Scand 2008; 118(4):305-314.

  111. Weller SC, Baer RD, Garcia de Alba Garcia J, Salcedo Rocha AL. Susto and nervios: Expressions for stress and depression. Cult Med Psychiatry 2008; 32(3):406-420.

  112. Barg FK, Huss-Ashmore R, Wittink MN, Murray GF et al. A mixed-methods approach to understanding loneliness and depression in older adults. J Gerontol B Psychol Sci Soc Sci 2006; 61(6):S329-39.

  113. Office of Behavioral and Social Sciences Research, A. Best practices for mixed methods research in the health sciences; http://obssr.od.nih.gov/scientific_areas/methodology/mixed_methods_research/index.aspx; consultado el 29 agosto de 2011.

  114. Glass TA, McAtee M. Behavioral science at the crossroads in public health: Extending horizons, envisioning the future. Soc Sci Med 2006; 62:1650-1671.

  115. National Institute of Mental Health. National Institute of Mental Health Strategic Plan. Washington, D.C.: National Institutes of Health; 2008.

  116. Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Improving the Quality of Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington D.C.: National Academies Press; 2006.

  117. U.S. Department of Health and Human Services. Mental Health: A Report of the surgeon general — older adults and mental health. Rockville, Maryland: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999.

  118. U.S. Department of Health and Human Services. Mental Health: Culture, Race and Ethnicity. A supplement to mental health: A report of the surgeon general. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2001.

  119. Switzer J, Wittink M, Karsch BB, Barg FK. «Pull yourself up by your bootstraps»: A response to depression in older adults. Qualitative Health Research 2006; 16(9):1207-1216.

  120. Bogner HR, Dahlberg B, de Vries HF, Cahill E et al. Older patients’ views on the relationship between depression and heart disease. Fam Med 2008;40(9):652-657.

  121. Bogner HR, Richie MB, de Vries HF, Morales KH et al. Depression, cognition, apolipoprotein e genotype: Latent class approach to identifying subtype. American J of Geriatric Psychiatry 2009; 17:344-352.

  122. Joo JH, Wittink M, Dahlberg B. Shared Conceptualizations and Divergent Experiences of Counseling Among African American and White Older Adults. Qual Health Res 2011;21(8):1065-1074.

  123. Wittink MN, Dahlberg B, Biruk C, Barg FK. How older adults combine medical and experiential notions of depression? Qualitative Health Research 2008;18(9):1174-1183.

  124. Wiittink MN, Joo JH, Lewis LM, Barg FK. Losing faith and using faith: Older African Americans discuss spirituality, religious activities and depression. J Gen Intern Med 2009; 24(3):402-407.

  125. Moreno P, Saravanan Y, Levav I, Kohn R et al. Evaluation of the PAHO/ WHO training program on the detection and treatment of depression for primary care nurses in Panama. Acta Psychiatr Scand 2003; 108(1):61-65.

  126. Gilbody S, Bower P, Fletcher J, Richards D et al. Collaborative care for depression: A cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med 2006; 166(21):2314-2321.

  127. Christensen H, Griffiths KM, Gulliver A, Clack D et al. Models in the delivery of depression care: A systematic review of randomized and controlled intervention trials. BMC Fam Pract 2008; 9:25.

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