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"Mental health problems in primary care are common. The range of mental health problems encountered by a general practitioner is large, and includes for example: adjustment reactions (normal responses to external circumstances); short or longer term disability associated with symptoms of depression and anxiety (which can be defined psychiatrically with diagnoses such as depression, but can also be seen as socially constructed); and schizophrenia and bipolar disorder (with a clearer biological basis, more easily defined from symptoms, but also with significant social meaning and consequences). These can co-exist with each other, and also with problems related to consumption of alcohol or drugs, and with problems resulting from difficult traits and personality types.." (1).
NICE suggest that screening for depression should be undertaken in primary care and general hospital settings for depression in high-risk groups - for example, those with a past history of depression, significant physical illnesses causing disability, or other mental health problems, such as dementia....
There are various screening tools which exist to assess the severity of depression such as the Beck depression inventory
NICE use diagnostic criteria based on DSM IV diagnostic classification
Considering management of mild depression in primary care:
Cognitive behaviour is a treatment modality that may be used in the primary care management of mild or moderate depression. What is cognitive behaviour therapy?
How does the evidence base for antidepressant treatment for mild depression compare with the evidence base for treatment of moderate/severe depression?
If a patient has moderate depression and is managed with antidepressant medication in primary care:
If a patient has a history of coronary heart disease, what is the selective serotonin reuptake inhibitor (SSRI) of choice?
When starting and monitoring antidepressant treatment in primary care:
If considering failure to respond/partial response to therapy?
When stopping antidepressant therapy:
Antidepressants in pregnancy:
Referral from primary care: