Guideline adherence in depression outcome measurement: a retrospective cohort study from Swedish psychiatric outpatient care

Even under conservative criteria, minimal outcome measurement was documented in fewer than one-third of depression treatment episodes. Adherence was particularly low in pharmacotherapy and traditional psychotherapy but substantially higher in iCBT, reflecting the advantages of automated, integrated digital workflows. These findings underscore that policy guidelines alone are insufficient; scalable implementation of MBC requires integrated digital systems, structured workflows, and targeted clinician support.