Depression in primary care: part 2-management.
Parashar Ramanuj1,2, Erin K Ferenchick3, Harold Alan Pincus4,5,6
1Center for Family and Community Medicine, Columbia University Medical Center, New York, NY, USA.
BMJ (Clinical Research Ed.)
|April 10, 2019
Summary
This review guides primary care providers on evidence-based depression treatment, including lifestyle, medication, and psychological interventions. It also covers organizational strategies for effective depression management in primary care settings.
Area of Science:
- Primary Care Medicine
- Psychiatry
- Public Health
Background:
- Depression is a common, chronic, and heterogeneous condition frequently encountered in primary care.
- Primary care providers (PCPs) are crucial in managing depression and its comorbidities but face diagnostic and treatment challenges.
- This is the second part of a series, focusing on treatment after the first part covered screening and diagnosis.
Purpose of the Study:
- To provide primary care providers with an evidence-based approach to treating depression.
- To detail recommended individual-level interventions (lifestyle, pharmacologic, psychologic).
- To highlight organizational strategies for improved depression management in primary care.
Main Methods:
- Review of evidence for depression treatment interventions in primary care.
- Synthesis of recommendations for lifestyle modifications.
- Compilation of guidelines for pharmacologic and psychologic therapies.
- Analysis of organizational strategies for care delivery.
Main Results:
- Recommended individual interventions include lifestyle changes, pharmacotherapy, and psychotherapies.
- Organizational strategies involve integrated care models and enhanced PCP support.
- Evidence supports a multi-modal approach tailored to patient needs.
Conclusions:
- Primary care settings require comprehensive strategies for effective depression treatment.
- Integrating individual and organizational approaches can improve patient outcomes.
- Continued evidence-based practice is essential for managing depression in primary care.
Related Concept Videos
01:05Long-term Depression
33.2K
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
33.2K
01:03Long-term Depression
3.2K
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over...
Calcium Ion Concentration Mechanism
If over...
3.2K
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
871
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
871
03:12Freezing Point Depression and Boiling Point Elevation
39.8K
Boiling Point Elevation
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...
39.8K
01:28Depressants
394
Depressant drugs, including alcohol and sedative-hypnotics, diminish central nervous system activity by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces brain activity and promotes relaxation. These substances can have various therapeutic uses but also pose significant risks, especially when misused or combined.
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
Alcohol is a common depressant that can induce a sense of relaxation and reduced inhibition at low doses. Contrary to its occasional...
394
01:18Depression: Overview
822
Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
822