Culpepper Larry
Department of Family Medicine, Boston University School of Medicine, Boston, MA 02118-2393, USA.
Postgrad Med. 2003 Nov;114(5 Suppl Treating):26-38. doi: 10.3810/pgm.11.2003.suppl29.160.
Caring for patients with depression who have comorbid medical conditions is a major challenge for primary care physicians. Depression is often difficult to diagnose in a primary care setting, and comorbidity vastly complicates diagnosis because of physiologic interactions and shared symptoms. Furthermore, physicians face the difficulty of developing a treatment plan that improves the outcome of multiple conditions at the same time. Fortunately, because of the recent development of effective and well-tolerated antidepressants, successful treatment and long-term management of depression are relatively straightforward and often greatly improve the status of the comorbid illness as well by improving overall function, treatment adherence, recovery rates, and survival time.
对患有合并症的抑郁症患者进行护理，是初级保健医生面临的一项重大挑战。在初级保健环境中，抑郁症往往难以诊断，而合并症由于生理相互作用和症状重叠，会使诊断变得极为复杂。此外，医生还面临着制定能同时改善多种病症治疗效果的治疗方案的困难。幸运的是，由于近期有效且耐受性良好的抗抑郁药的研发，抑郁症的成功治疗和长期管理相对简单直接，而且往往通过改善整体功能、治疗依从性、康复率和生存时间，也能极大地改善合并症的病情。
