Depression: an evidence-based first consultation

Abstract

Applying the label of depression at the first consultation can be problematic as it can be upsetting news to receive, and giving a label such as depression as part of an initial brief primary care consultation is likely to be wrong. There may be a new term in the International Classification of Diseases-11 called “anxious depression” which includes mixed anxiety and depression. The prevalence of depression in a clinical setting will be higher than in an asymptomatic screening population and the activity is thus considered to be “case finding”. A Cochrane review found that exercise is moderately more effective than a control intervention for reducing symptoms of depression, but no more effective than psychological or pharmacological treatments. In a 2016 randomised controlled trial, M. Hallgren found that exercise is beneficial for depression even when it is light as opposed to moderate and vigorous and when conducted once per week.