Phone calls, email may stem depression relapse

After an acute episode of depression, doctors know that patients can slip back into the darkness. They even have a name for the depression relapse—”dysthymia.” Now a UW study of patients at risk found that several brief office visits along with continuing telephone calls or even e-mail can help prevent a relapse.

Interventions spaced throughout a 12-month follow-up period helped patients show a significant improvement in their adherence to an anti-depressant medication program, says Wayne Katon, UW professor of psychiatry and behavioral sciences. New technology is helping other patients as well. Researchers for other chronic diseases, such as diabetes and asthma, are finding that phone calls or e-mail can be effective ways to improve patient adherence to treatment plans, Katon says.

“We’ve found that our patients actually like using the telephone this way, as follow-up on their clinical treatment,” Katon says. “It’s the convenience. We’re finding that patients actually are more satisfied with these interventions. They get closer contact than usually occurs in the typical course of care for depression.”

Katon noted that this study was the first primary care-based effectiveness study of trying to prevent relapse in depression patients. “This study was unique in that it was done in a primary care setting, with people being treated by primary care physicians,” Katon says. “The other difference was in the use of briefer interventions. Rather than setting up multiple office visits, as is done for depression patients in most studies, we focused on briefer meetings but long-term interventions in a wider range of patients.”

He added that many victims of depression are so busy that traveling repeatedly to a doctor’s office simply isn’t feasible. “Since most of the self-care for chronic conditions occurs at home,” Katon says, “telephone monitoring, advice, education and support may be very effective in changing health habits. These are very hard to change for all of us.”