The modern intensive therapy of depressive patients takes into account a complex illness mechanism including biological, psychological and (multiple) social aspects. Especially with regard to the social aspects, it is necessary that a medical opinion on the unfitness for work is to be included and therapeutic intervention be taken before the depressive illness becomes chronic. Case management initiated by a private insurance company in the early stages of the depressive illness is therefore necessary. Furthermore, it is very important that all therapeutic efforts follow the guideline: if therapeutic improvement can be achieved, therapy continues. Otherwise, a final medical opinion regarding unfitness for work takes priority. The outstanding difference betweenintensive therapy and the usual type of therapy is that everything, from the therapy itself to the medical opinion, is co-ordinated, discussed and carried out within one team. By following this guideline for the intensive therapy of depression, a marked reduction in long-term unfitness for work could be achieved.
