Hegerl U, Schönknecht P
Klinik und Poliklinik für Psychiatrie, Universitätsklinikum Leipzig AöR, Semmelweis-Strasse 10, 04103, Leipzig.
Nervenarzt. 2009 May;80(5):532-4, 536-9. doi: 10.1007/s00115-008-2622-z.
Minor depression, subsyndromal depression and subthreshold depression are frequent conditions in primary care which do not fulfil the criteria of a depressive disorder but are associated with functional disability, impairment of quality of life, and health care use. This paper reviews studies on the clinical evidence of pharmacotherapy, psychotherapy, and interventions to improve primary care. In this regard, whether clinical relevance of antidepressant therapies can be concluded from differences between placebo and active treatment is critically discussed. Due to lacking clinical evidence, aspects of a pragmatic therapeutic approach in those patients are presented.
轻度抑郁、亚综合征性抑郁和阈下抑郁在初级保健中很常见,这些情况虽不符合抑郁症的诊断标准,但与功能残疾、生活质量受损及医疗保健利用有关。本文综述了关于药物治疗、心理治疗以及改善初级保健干预措施的临床证据的研究。在这方面,对能否从安慰剂与活性治疗的差异得出抗抑郁治疗的临床相关性进行了批判性讨论。由于缺乏临床证据,还介绍了针对这些患者的实用治疗方法的相关方面。