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• W2183630568 abstract "While family physicians play a leading role in caring for patients with major depression, the quality of that care that could be greatly improved. A 1997 to 1998 survey of a national sample of adults with depressive or anxiety disorders revealed that 83% of these patients visited a health care provider. 1 Of this total, 84% were treated by primary care clinicians, compared with 16% who were treated by mental health professionals. However, about 90% of those cared for by mental health professionals received treatment that met criteria for adequacy outlined in treatment guidelines, compared with 19% of those cared for by primary care professionals. A critical role for family physicians is to integrate treatment of depression with that of other conditions, especially in light of the association of depression with a variety of chronic diseases. The Institute of Medicine has concluded that depression is strongly associated with the occurrence of, and death following, myocardial infarctions. 2 In diabetes, depression is associated with a 2% increase in glycosylated hemoglobin levels 3 and can predict occurrence of diabetic complications. Additionally, chronic illnesses may, in themselves, exacerbate depression several fold. Primary care clinicians are ideally positioned to serve as the central health care providers for patients with major depression. These physicians have many attributes that support this role, including their longitudinal relationship with patients, response to undifferentiated problems, frequent use of the biopsychosocial model, and ability to integrate care of mental and medical conditions. However, challenges in fulfilling this role also exist, including difficulties in recognizing patients with major depression, developing an adequate diagnostic initial assessment, implementing effective short- and long-term treatment and management strategies, and integrating care of depression with that of other conditions affecting patients. 4 This article will review each of these challenges." @default.
• W2183630568 created "2016-06-24" @default.
• W2183630568 creator A5047943489 @default.
• W2183630568 date "2002-09-01" @default.
• W2183630568 modified "2023-09-23" @default.
• W2183630568 title "The active management of depression." @default.
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