The study will enable us to check the validity for our patients of pre-suppositions on depression in primary care obtained from studies in other countries with different health structures and social and cultural conditioners, and to find diverse information extrapolated from specialist studies.

Objective: To determine the rate of relapse in a cohort of patients with severe mental disorder (SMD), during a two year period, before joining a workplace reintegration program run by the Pere Mata Foundation (Reus, Tarragona, Spain) and to compare this information with the rate of relapse during the two subsequent years. We sought to compare both periods to determine if any differences existed in number of patients admitted and duration of stay, as well as the number of times the patients contacted the ambulatory facilities. Methods: A fixed historical cohort of 86 subjects with SMD was monitored for two years before, and for two years after, joining the workplace reintegration program. Results: The number of patients admitted to the hospital and the length of time they spent there decreased significantly after they had joined the program, as did the number of patients who contacted the ambulatory facilities. The length of time without relapses increased after joining the program (χ2 for Log Rank=4.46 df=1 p=0.035), and the rate of relapse before joining the program was 39% but fell to 18% after joining. The relative risk (RR) of having a relapse was greater during the observation period before joining the program than in the observation period after joining (RR 2.13 95% CI 1.27-3.55 p=0.002). Conclusions: Integrated clinical treatment combined with participation in a workplace reintegration program improved the clinical functioning of patients with SMD, decreased the number and length of hospital admissions, increased the length of time without relapse and reduced the patients' use of ambulatory facilities.

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