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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
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Depression in primary care: current and future challenges.

Marilyn A Craven1, Roger Bland

  • 1AsDepartment of Psychiatry and Behavioural Neurociences, McMaster University, Hamilton, Ontario, Canada. cravenm@mcmaster.ca

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|August 27, 2013
PubMed
Summary
This summary is machine-generated.

Family physicians (FPs) face challenges in detecting and treating major depressive disorder (MDD). Low detection and treatment rates persist, necessitating improved strategies for integrated care, especially for aging populations with chronic diseases.

Keywords:
chronic diseasecollaborative caredisease managementepidemiologymajor depressive disorderprimary health carerecognitiontreatmenttreatment adequacy

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Area of Science:

  • Primary Care Medicine
  • Mental Health Research
  • Geriatric Psychiatry

Background:

  • Major Depressive Disorder (MDD) affects approximately 10% of primary care patients.
  • Prevalence of MDD is increasing due to an aging population and rising chronic disease rates.
  • A strong bidirectional relationship exists between MDD and chronic physical conditions.

Purpose of the Study:

  • To assess the current knowledge regarding family physician (FP) detection and treatment of MDD.
  • To identify practice gaps, challenges, and potential interventions for improving MDD care in primary care settings.

Main Methods:

  • Literature review focusing on systematic reviews and meta-analyses concerning MDD in primary care.
  • Analysis of prevalence, detection rates, treatment adequacy, and the impact of aging and chronic disease.
  • Evaluation of interventions aimed at enhancing MDD recognition and management.

Main Results:

  • Detection and treatment rates for MDD in primary care remain low.
  • Treatment quality is often suboptimal, lacking adequate follow-up and monitoring.
  • Collaborative care and case management models show potential benefits.

Conclusions:

  • Addressing low MDD detection and treatment rates is crucial.
  • Further research is needed to understand why FPs may not initiate treatment despite detection.
  • Integrated care models for concurrent treatment of MDD and chronic diseases are essential for middle-aged and elderly patients.