Study flow chart. PCP: primary care physician. MDD: major depressive disorder. First stage: PCP randomization (September 2009) and implementation of the intervention (October 2009 to March 2010). Second stage: collection of patient data (April to July 2010). Selection of patients for screening in the second stage: Every 10th attending patient was evaluated (n = 3737) by the PCP with the Depression subscale of the Hospital Anxiety and Depression Scale. Confirmation of MDD in the study sample was done with the Mini-International Neuropsychiatric Interview.