Managing depression in primary care
- 7 April 2005
- Vol. 330 (7495), 800-801
- https://doi.org/10.1136/bmj.330.7495.800
Abstract
Public confidence needs to be restored after concerns over the safety of SSRIs D epression is a condition of “particular concern, which costs lives and affects the quality of life,” according to UK prime minister Tony Blair.1 Nine out of 10 depressed patients are treated only in primary care,2 3 and up to two thirds of suicide victims contact a general practitioner in the four weeks before the death.4 For years, however, general practitioners have been criticised for failing to deal adequately with depression. Like hypertension, depression is subject to a rule of halves—only half of depressed patients seek help from doctors, half are detected in primary care, half receive treatment with only half completing it: fewer than 10% finish a therapeutic course of treatment.5 A range of initiatives, often erroneously based on educational models for general practitioners, has aimed to improve detection rates and to increase the appropriateness of prescribing in depression with variable success, including a spectacular failure, in Hampshire, to influence general practitioners' behaviour at all.6 There are many reasons why depression goes unrecognised in primary care. …This publication has 8 references indexed in Scilit:
- Frequency of consultations and general practitioner recognition of psychological symptoms.2004
- Improving access to depression care: descriptive report of a multidisciplinary primary care pilot service.2004
- Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: Randomised controlled trialThe British Journal of Psychiatry, 2004
- Effects of a clinical-practice guideline and practice-based education on detection and outcome of depression in primary care: Hampshire Depression Project randomised controlled trialThe Lancet, 2000
- Suicide and recency of health care contactsThe British Journal of Psychiatry, 1998
- Depression in the community: the first pan-European study DEPRES (Depression Research in European Society).1997
- Depression in the communityInternational Clinical Psychopharmacology, 1997
- Lay people's attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launchBMJ, 1996