1,721,203 research outputs found
Selective serotonin reuptake inhibitors are more tolerable than tricyclic antidepressant drugs
No full textThe newer, 'atypical' antipsychotic drugs--their development and current therapeutic use
No full textGeneral practitioners (GPs) need to become more aware of a new generation of antipsychotic drugs that are 'atypical' in that, unlike traditional neuroleptics, they do not cause extrapyramidal side-effects; they may also be more effective against both the positive and negative symptoms of schizophrenia by their actions on various neurotransmitter pathways in the brain. This is a non-systematic review of the development of these new drugs and outlines how they are currently being used. It includes information found from an electronic search of the databases MEDLINE (from 1966 to June 1998) and EMBASE (from 1980 to January 1998) using the combined search terms 'antipsychotic agents', 'atypical', and 'schizophrenia
Depression management clinics in general practice? Some aspects lend themselves to the mini-clinic approach
No full textIn 1979 Stott and Davis identified the four areas of exceptional potential to serve patients in every primary care consultation, which included management of continuing problems along with management of the presenting problem, opportunistic health promotion, and modification of help seeking behaviour.1 However, we now know that chronic diseases are often more effectively managed through special clinics outside routine consultations, usually staffed by practice nurses. Such "mini-clinics" have been shown to improve the outcome of asthma2 and diabetes3 and are now widespread in British general practice, encouraged by separate payments for chronic disease management. Might this approach also be applied to depression? <br/
Depression in adults: GPs are not so bad at diagnosis
No full textTimonen and Liukkonen state that, according to cross sectional studies, 50-70% of patients with depression in primary care remain undetected.1 This attack on GPs’ ability to recognise depression is out of date and should not go unchallenged. Studies have shown that many missed cases have relatively mild symptoms, that lie just above the threshold on screening measures for depression. These cases have dubious clinical relevance and may be false positives because all diagnostic measures have rating errors.2 In addition, cross sectional recognition rates are obtained from a single 10 minute consultation and usually exclude patients whom GPs have already recognised as depressed. The article fails to acknowledge studies showing that many "missed" patients are diagnosed correctly at later visits. Kessler et al found that, although many patients with depression did not receive a diagnosis at a single consultation, most were given one at later consultations or recovered without a GP’s.<br/
Healthcare assistant case management may reduce depression symptoms in primary care patients with major depression more than usual care
No full textCommentary on: Gensichen J, von KM, Peitz M, et al. Case management for depression by health care assistants in small primary care practices: a cluster randomized trial. Ann Intern Med 2009;151:369–78
Depression as a risk factor for ischaemic heart disease in men: two other community studies show similar findings
No full textHippisley-Cox et al showed the great potential of high quality general practice computer databases for use in epidemiological research in their elegant study of depression as a risk factor for ischaemic heart disease in men
Why can't GPs follow guidelines on depression? We must question the basis of the guidelines themselves
No full textThe Hampshire depression project, published recently, was a large well designed randomised controlled study of teaching practitioners about the recognition and management of depression and using patient improvement as the outcome measure. Its results were disappointingly negative, failing to show any increase in recognition or patient recovery rates.1 These findings herald the need for a major change in thinking about improving the management of depression in primary care. <br/
Letter
No full textCoughing test to diagnose peritonitis may not have same predictive value in general practic
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