BASIC ASPECTS OF PATIENT MANAGEMENT WITH DEPRESSION IN A FAMILY MEDICINE PRACTICE

(based on the experience of Slovenia and Croatia)

Abstract

In the practice of a general practitioner (family doctor) with two thousand registered patients according to the average European prevalence of depression – 5 % are dealing with about 100 patients (70 women and 30 men) who have been diagnosed with depression. Each year, two patients are hospitalized for depression, and day about – suicide.

The aim – to analyze the key aspects of managing patients with depression in primary care (PCP) practice.

Discussion. Depression is one of the biggest health problems. Ways of resolving depression are good education, appropriate depression management, and realistic expectations of therapy, given that only 20 % of patients experience only one episode of depression and 30 % of patients do not respond to therapy. Good relationships family doctors with their patients are especially important in the treatment of depressed patients. The formation of the patient’s attitude to the disease depends on the patient’s assessment of the patient’s condition. There is a need for a clear ability to use depression screening tools in the practice of PMD: the Beck Depression Scale (BDI), the Zung Self-Depression Scale (SDS), the Geriatric Depression Scale, and the Hamilton Depression Rating Scale (HAM-D).

Conclusions. Depression should be treated in the presence of anxiety symptoms. The risk of suicide is four times higher in patients with depression than in the general population. Depression impairs physical health and overall quality of life. This is associated with an increased risk of coronary heart disease, stroke, pain syndromes, alcohol abuse, smoking and illicit drug use. This determines the relevance of the problem of depression at the stage of primary care.