BOSTON, MA — Most people who seek help for depression first visit
their primary care doctors. So these professionals, along with mental
health professionals and insurers, have been looking for ways to better
identify and treat depression in the primary care setting, reports the
September issue of the Harvard Mental Health Letter.
patients are often reluctant to bring up the subject with their
doctors, so a short but valid screening test could help with detection
and diagnosis. The Mental Health Letter says doctors might
start by asking patients two questions: Over the past two weeks, have
you felt down, depressed, or hopeless? Over the past two weeks, have
you felt little interest or pleasure in doing what you normally do?
Studies suggest that almost every patient who needs treatment for
depression will answer yes to at least one of these questions.
new approaches focus on managing the treatment of depressed patients.
In one program, for example, a depression care manager provided
telephone checkups and a relapse prevention plan, and patients were
referred to a psychiatrist if they did not improve. Nearly half of
patients in the program showed a reduction of at least 50% in
depressive symptoms, compared with 19% in usual care, and differences
persisted even a year after the program ended.
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