[Severe depression : the doctor/patient relationship]

The relation between doctor and patient is of great importance in clinical practice. For treating depression, a patient-centered model of practice helps to acquire necessary diagnostic information, but also to understand the patient's subjective experience of presenting problems and the patient's psychosocial context. That seems to be an important point to focus on in clinical practice, to improve the treatment of depressed patients. On the other hand, depressed patients with higher involvement in medical decisions have a higher probability of improving their symptoms. Interventions to increase patient involvement in decision-making may be an important mean of improving care for and outcomes of depression. One of the goals clinicians may have, is to achieve shared understanding between patient and themselves about the patient's problems and their treatment.