GP psychoeducation sessions show no significant effect on depressive symptoms in primary care patients

INTRODUCTION: In most countries, including Germany, people with depression first consult their general practitioners (GP). However, structural and individual circumstances in primary care (PC) often hinder GPs from offering guideline-compliant treatment. A psychoeducational program was adapted to the primary care setting to improve treatment in PC. In a cluster-randomized controlled trial, the new program was compared to treatment as usual (TAU) regarding its effectiveness and feasibility. METHODS: 22 GPs in Bavaria and 121 PC patients with depressive symptoms were included through cluster randomization and patients either received four individual psychoeducation sessions by their GPs or TAU. Repeated self-report measures were conducted at baseline (t0), 3-months-follow-up (t1) and 6-months-follow-up (t2). Linear mixed models were calculated for the change in depressive symptoms, depression literacy and patient activation. The feasibility was evaluated based on systematic feedback collected from both GPs and patients. RESULTS: The primary outcome of this cRCT, change in depressive symptoms from t0 to t1, measured by BDI-II total score, was not statistically significant. However, significant effects were found for two secondary outcomes: depression knowledge and patient activation. Both patients and GPs found the program to be helpful and feasible and it received positive feedback. DISCUSSION: Both patients and general practitioners regarded the adapted psychoeducational program as a valuable and feasible tool to improve the treatment of depression in primary care. While the current sample size limits the assessment of the program's effectiveness, preliminary results highlight its positive impact on depression knowledge and patient activation. Future studies should aim for a larger sample size and emphasize the delivery of more detailed psychoeducational content.