Minor depression, subsyndromal and subthreshold depression are frequent conditions in primary care which do not fulfil the criteria of a depressive disorder but are associated with functional disability, impairment of quality of life, and health care use. The symposium will discuss studies on the clinical evidence of pharmacotherapy, psychotherapy, and primary care improving interventions. To this concern, it will be critically discussed if clinical relevance may be concluded from placebo-verum-differences of the respective studies, with respect to psychopharmacological and psychotherapeutic approaches. Pragmatic therapeutic approaches in those patients due to lacking clinical evidence will be introduced. Moreover, the symposium will emphasize when exploring the efficacy of antidepressants in depression the core items depression have to be considered as demonstrated in recent studies. The relation between baseline severity of depression and outcome in clinical trials will be critically discussed. Although symptom severity is a most important issue when treating depression in primary care the relationship between patients’ treatment preference and the treatment they actually are evident and will be addressed in the symposium.