University of California, San Francisco, and Department of Veterans Affairs Medical Center, San Francisco, CA 94121, USA.
JAMA. 2012 May 2;307(17):1848-57. doi: 10.1001/jama.2012.3466.
Approximately 1 in 10 primary care patients has major depressive disorder, and its presence is associated with poor health outcomes in numerous medical conditions. Using the case of Mr J, a 52-year-old man with depressive symptoms and several comorbid medical conditions, diagnosis and treatment of depression are discussed. Specific topics include evidence regarding appropriate depression screening and diagnosis, the importance of team-based care, patient self-management, exercise, structured psychotherapy, pharmacotherapy, monitoring of therapy, and indications for referral.
大约每 10 名初级保健患者中就有 1 名患有重度抑郁症，其存在与许多医疗条件下的不良健康结果相关。通过 52 岁的有抑郁症状和多种合并症的患者 Mr J 的病例，讨论了抑郁症的诊断和治疗。具体主题包括适当的抑郁症筛查和诊断的证据、团队护理的重要性、患者自我管理、运动、结构化心理治疗、药物治疗、治疗监测以及转诊指征。
