Review article Healthcare team training programs aimed at improving depression management in primary care: A systematic review Paul A. Vöhringer a,b,c , Ariel Castro d , Pablo Martínez a,b,e,n , Álvaro Tala a , Simón Medina f , Graciela Rojas a,b a Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Santiago, Chile b Millennium Institute for Depression and Personality Research (MIDAP), Santiago, Chile c Mood Disorders Program, Tufts Medical Center, Tufts University, Boston, USA d Clinical Hospital, Universidad de Chile, Santiago, Chile e School of Psychology, Faculty of Humanities, Universidad de Santiago de Chile, Santiago, Chile f School of Medicine, Faculty of Medicine, Universidad de Chile, Santiago, Chile article info Article history: Received 12 January 2016 Accepted 16 April 2016 Available online 21 April 2016 Keywords: Depressive disorder Education Primary health care Systematic review abstract Background: Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Methods: Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or re- sponse rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Results: Nine studies were included in this systematic review. Five trials tested the effectiveness of multi- component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Limitations: Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a con- founding factor. Conclusions: The review conducted suggests that stand-alone training programs are less effective than multi- component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. & 2016 Published by Elsevier B.V. Contents 1. Introduction ........................................................................................................ 142 2. Methods ........................................................................................................... 143 3. Results ............................................................................................................ 143 4. Discussion ......................................................................................................... 144 References ............................................................................................................. 146 Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jad Journal of Affective Disorders http://dx.doi.org/10.1016/j.jad.2016.04.029 0165-0327/& 2016 Published by Elsevier B.V. Abbreviations: LMICs, Low and Middle-Income Countries; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RCT, Randomized Controlled Trial; HAM-D, Hamilton Depression Rating Scale; CES-D, Centre for Epidemiological Studies-Depression Scale; EPDS, Edinburgh Postnatal Depression Scale (EPDS); HAD, Hospital Anxiety and Depression; PHQ-9, Patient Health Questionnaire n Corresponding author at: Department of Psychiatry and Mental Health, Clinical Hospital, Universidad de Chile, Av La Paz 1003, Recoleta, Santiago, Chile. E-mail address: pablo88.martinezdiaz@gmail.com (P. Martínez). Journal of Affective Disorders 200 (2016) 142–147