Guideline Based Diagnosis and Treatment of Unipolar Depressions in Family Medicine

DOI: 10.3238/zfa.2019.0413-0418

german translation / full article

Paul Delker, Caroline Jung-Sievers, Wilhelm Niebling, Florian Wolf, Tom Bschor, Martin Hautzinger, Christine Kühner, Jürgen Matzat, Henning Schauenburg, Frank Schneider, Mathias Berger, Holger Schulz, Martin Härter, Jochen Gensichen

Keywords: depressive disorder evidence-based guideline primary health care

BackgroundSearch methodGuideline-based diagnosis and treatment of unipolar depression in line with the current National Health Care Guideline (NVL) for primary care physicians.Main messagesThe exact recording of major and secondary symptoms is essential for a correct classification according to ICD-10. In each patient with a depressive disorder, suicidality should be assessed on a regular basis and explored if necessary. It is advisable to implement basic psychosomatic care in family practice. Psychotherapy alone without psychopharmacological therapy should only be recommended for mild and moderate episodes. In severe episodes and chronic courses, combined therapy is superior to psychotherapy alone.The choice of antidepressant should be individualized based on the side effect profile, the patient’s preferences and the family physician’s experience. ECG and laboratory control may be necessary at baseline and during the course. Regular therapy monitoring of adherence and treatment effects at fixed intervals is essential. In order to reduce the likelihood of recurrence, the minimum therapy duration and necessity of maintenance and recurrence prevention in psycho- and pharmacotherapy should be considered.ConclusionsDue to the long-term doctor-patient relationship, the family physician has a major role in the diagnosis and treatment of depression in the health care sector.KeywordsPrimary health care; depressive disorder; evidence-based guideline

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