Katon W, Sullivan M D
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
J Clin Psychiatry. 1990 Jun;51 Suppl:3-11; discussion 12-4.
Major depression is the most common clinical problem primary care physicians are called upon to diagnose and treat. Depression is associated with high medical care utilization, amplification of somatic symptoms and disability, poor self-care and adherence to medical regimens, and increased morbidity and mortality from medical illness. Despite the high prevalence and the maladaptive effects of major depression on patients' lives, this affective illness is often not accurately diagnosed or effectively treated. Double-blind, placebo-controlled studies have increasingly demonstrated efficacy of the antidepressant agents in primary care patients, patients with chronic pain, and patients with comorbidity--chronic medical illness and major depression.
重度抑郁症是基层医疗医生需要诊断和治疗的最常见临床问题。抑郁症与高医疗利用率、躯体症状和残疾的加重、自我护理差以及对医疗方案的依从性差有关，还与内科疾病导致的发病率和死亡率增加有关。尽管重度抑郁症患病率高且对患者生活有不良影响，但这种情感性疾病常常未得到准确诊断或有效治疗。双盲、安慰剂对照研究越来越多地证明了抗抑郁药在基层医疗患者、慢性疼痛患者以及合并症患者（慢性内科疾病和重度抑郁症患者）中的疗效。
