James M. Ferguson, MD
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Background: Much has been learned in recent
years about the diagnosis and treatment of depression, a serious,
commonly overlooked psychiatric illness often seen initially by
the primary care physician. The objective of this article is to
review the diagnosis and treatment of depression in primary care
practice.
Method: Relevant articles on depression were
identified by a comprehensive MEDLINE search and classified into
the following categories: diagnosis and screening,
nonpharmacologic therapy, pharmacologic therapy, newer
antidepressant agents, and maximizing antidepressant therapy. The
importance to primary care practice was considered in determining
the significance of each article reviewed.
Results: Because no laboratory tests exist for
depression and no biological markers can be measured routinely,
the diagnosis of depression must be made with a number of
reliable depression scales and questionnaires that can be
completed quickly in the primary care setting. The considerable
overlap between depressive and anxiety disorders further
complicates an accurate diagnosis. Remission (i.e., absence of
symptoms) is the ultimate goal of therapy for patients who have
depressive symptoms.
Conclusion: Many patients can be treated safely
and effectively for depression in the primary care setting with
pharmacologic therapy, which, if completely successful, can lead
to full remission of the disorder.
Prim Care Companion J Clin Psychiatry 2000;2(5):173-178
https://doi.org/10.4088/PCC.v02n0504
© Copyright 2000 Physicians Postgraduate Press, Inc.