Nease Donald E, Klinkman Michael S, Aikens James E
Dept. of Family Medicine, University of Michigan, Ann Arbor 48109-0708, USA.
Int J Psychiatry Med. 2006;36(2):141-51. doi: 10.2190/3FGL-EKXQ-EAG2-B1UF.
The current mandates for depression screening in primary care create a dilemma for clinicians. How should screening be implemented in the face of limited evidence for sustainable strategies for effective depression monitoring and management in primary care. In this article we review the issues surrounding primary care depression screening, and develop the argument for a case-finding strategy that includes careful choice of a single instrument, focused identification of high-risk patients, and systematic monitoring of outcomes. We believe this is a sustainable method that primary care clinicians can implement to address the spirit of current depression screening mandates.
目前初级保健中抑郁症筛查的要求给临床医生带来了两难困境。鉴于在初级保健中进行有效抑郁症监测和管理的可持续策略证据有限,应如何实施筛查呢?在本文中,我们回顾了围绕初级保健抑郁症筛查的问题,并提出了一种病例发现策略的论点,该策略包括谨慎选择单一工具、重点识别高危患者以及系统监测结果。我们认为这是一种初级保健临床医生可以实施的可持续方法,以符合当前抑郁症筛查要求的精神。