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The University of Southampton

Improving patient outcomes for depression

University of Southampton research into the management of depression highlighted deficits in how the illness was assessed and treated by GPs and demonstrated that education alone failed to improve performance. Our findings were included in national guidelines leading to questionnaire assessments being introduced into GP contracts. Recent trial evidence also shows improved patient outcomes.

Research Challenge

Depression is common, disabling and costly. More than 80% of cases are managed in primary care making effective management in this setting crucial. But in the 1990s GPs were failing to recognise around one-third of cases, and most patients received either no treatment, or their treatment was inadequate.


A Swedish study suggested education was the way to improve GP management of depression. Our researchers tested this study by undertaking a ground-breaking trial, the Hampshire Depression Project which showed that guideline-based GP education alone did not improve recognition of depression or patient outcomes.

Our Solution

Analysis of the process of care in the Hampshire Depression Project showed a lack of impact on appropriate targeting of treatment with only a small percentage of patients being prescribed antidepressants as recommended by guidelines.

Findings from our subsequent research showed this was due to inaccurate GP global assessment of severity. Consequently the National Institute for Health and Care Excellence (NICE) recommended questionnaire measures be considered at diagnosis and an indicator was introduced into the GP contract to promote their use.

Further research contributed to the introduction of a second indicator, at follow-up, and our studies showed that it appeared to influence GPs' decisions to change treatment appropriately

The Impact

Our research into depression assessment has had significant impact on UK healthcare guidelines, GP practice, and as recent trial evidence suggests, on patient well-being.

The 2009 NICE depression guidelines directly referenced our findings and the subsequent introduction of a formal rating scale had immediate and widespread impact on care.

Our observational research indicated that questionnaire assessment significantly improved the targeting of treatment for patients.

Our research into depression assessment has had significant impact on UK healthcare guidelines
Southampton informs NICE guidelines

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