Preskorn S H, Baker B S
Department of Psychiatry, University of Kansas School of Medicine, Wichita.
Dis Mon. 1995 Feb;41(2):73-140. doi: 10.1016/s0011-5029(05)80005-7.
Major depression is a serious, potentially life-threatening illness that can cause significant pain and suffering. It afflicts up to 50% of patients who are seen in the primary care setting. However, it is a remarkably treatable disorder, once it is recognized. The mainstay of treatment is education about the illness, brief supportive counseling, and antidepressant medication. This monograph is a synopsis of a book, Outpatient Management of the Depressed Patient, recently published on this subject. We focus on how to diagnose and treat major depression in the primary care setting, in which the vast majority of patients with this condition are seen. We review the condition itself, how to establish the diagnosis, what education and brief supportive counseling are needed and how to provide them, how to select an antidepressant, and how to use the drug to induce and maintain remission.
重度抑郁症是一种严重的、可能危及生命的疾病，会导致巨大的痛苦。在初级保健机构就诊的患者中，高达50%的人患有此病。然而，一旦被识别出来，它是一种完全可以治疗的疾病。治疗的主要方法是对该疾病进行教育、简短的支持性咨询以及使用抗抑郁药物。这本专题论文是最近出版的一本关于该主题的书籍《抑郁症患者的门诊管理》的概要。我们重点关注如何在初级保健机构中诊断和治疗重度抑郁症，绝大多数患有这种疾病的患者都是在初级保健机构就诊的。我们回顾了这种疾病本身、如何确立诊断、需要哪些教育和简短的支持性咨询以及如何提供这些，如何选择抗抑郁药物，以及如何使用药物诱导并维持病情缓解。
