[Depressive disorders in general medical practice, particularly in basic health care]

Early, correct treatment of depression as well as introduction of prophylactic procedures highly improves the prognosis in affective disorders. Periods of relapse become shorter, the risk of their occurrence decreases, the risk of suicidal attempts is much lower and the too high death rate in the younger age groups goes down. Epidemiological studies and analyses show that a large proportion of patients with depression does not receive any help of the health service, some receive psychiatric help and some contact general practitioners. The latest group constitutes 10-20% of patients coming to various institutions of basic health service. Only in 25% of this group depressive disorders are recognised, even less patients receive effective help. Physicians employed in basic health service often treat depression inappropriately (an erroneous selection of medicines, inappropriate, usually too low dosage of the drug, too short the period ot treatment). In order to improve the effectiveness of medical help provided to the patients with depressions, various educational actions for physicians employed in the basic health service are organised. Their aim is to improve the physicians' competence in diagnosing and treatment of depression. As the hitherto experience of execution of educational programs shows, the necessary condition of improving the efficiency of first contact physicians in treatment of patients with depression consists in providing them with opportunities to receive systematic supervision and consultation of psychiatrists.