depression severity

In this Viewpoint, we respond to the 2022 Lancet–World Psychiatric Association Commission’s call for united action on depression. We present primary care-focused recommendations synthesised from key outcomes of 16 observational cohorts of adults with depression in primary care, representing more than 26 000 individuals from 26 countries. Identified areas for action included prediction of the depression severity trajectory, the complexity of the depressive experience, and the need for tailored yet holistic depression-care plans. Personal resilience and reductions in social burden were identified as powerful predictors of improved depression outcomes. Aimed at policy makers in primary care, researchers, and primary care providers, our recommendations emphasise a generalist model of care that is person focused and trauma informed. We advocate for increased primary care capacity for depression risk prediction, social support integration, care navigation, and continuity of care. By bridging the gap between primary care and psychiatric knowledge, our recommendations provide actionable guidance for reducing the global burden of depression.