Description

Clinical depression is currently the leading cause of disability in the USA and is expected to become the second leading cause of disability worldwide (after heart disease) by the year 2020, according to the World Health Organization. The economic cost is, therefore, high. Most people with a depressive illness do not seek treatment or are unrecognised in primary care, although the great majority can be successfully treated because there are now effective medications and psychosocial therapies.

The 10-minute consultation: depression is an authoritative and accessible guide for the primary care clinician to assist treatment decisions. The handbook covers diagnosis, prevention, treatment and management, and includes drug reference tables (with contraindications, drug interactions and side effects), clinical trial information that support the best-practice guidelines and links to supplementary resources for both clinicians and patients.

The clinician's manual is designed to be used in the clinic and for studying, containing targeted guidance on all aspects of the primary care clinician's role.

Written by experienced key opinion leaders, the book supports everyday patient care and improved outcomes.


Table of contents

1. Introduction

How is depression classified?

What is the natural history of depressive illnesses?

What are the effects of depression on daily functioning and quality of life?

2. Who and what to test

Screening and case finding

What issues should the GP cover during the 10-minute consultation?

3. How to manage the patient with depression

Who to treat?

How to treat?

Preventing new episodes of depression

Acute-phase management

Maintenance-phase management

Co-morbidity (including substance abuse/alcohol and drug dependency, somatic

symptoms, personality/eating disorders, other general medical conditions [eg stroke,

dementia, cancer, diabetes and HIV/AIDS] and other co-morbid psychiatric disorders

[eg anxiety])

4. Person-centred care

How to identify the patient’s beliefs about depression and its complications

(concerns and expectations)?

What are the patient’s cultural beliefs and practices?

How to recognise non-concordance?

Are any treatments particularly appropriate?

5. Applying the evidence

What are the implications of the international best-practice guidelines for GPs?

Selected landmark studies

What are the GP prescribing options for tackling depression in primary care: a summary

When to refer?

6. Review and recall

What ongoing patient care, monitoring and follow-up are necessary?

What roles do other key healthcare workers have in managing the patient?

What is the role of information technology (IT)?

What is the role of the expert patient?
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