Managing depression in primary care

Abstract

Depression is one of the commonest health conditions worldwide. According to the Hong Kong Mental Morbidity Survey, a recent territory-wide psychiatric epidemiological study interviewing 5,719 randomly selected residents in Hong Kong, the 1-week prevalence of mixed anxiety and depressive disorder and depressive episode are 6.9% and 2.9% respectively. It is now recognised that depression not only results in significant morbidity, but also increases suicidal as well as non-suicidal mortality. Primary care physicians play an important role in the management of persons with depression, especially those with mild to moderate depression. In a cross-sectional study surveying more than 10,000 patients attending 59 local primary care clinics, one in ten were screened positive for depression. However, only 23.1% of them were diagnosed. Among those who were diagnosed, 43% were prescribed with antidepressants, 11% with benzodiazepines, 42% with counseling and 9% were referred to counsellors or other healthcare professionals. Detection and management of depression is complex. The present talk will cover the barriers and facilitators to depression management at primary care, comprehensive assessment, safety evaluation, and an update of evidence-based pharmacological and non-pharmacological treatment for depression.