An end to depression in primary care?

摘要

It is time to consider alternatives to diagnosing and treating depression in primary care. GPs’ prescribing of antidepressants continues to increase, but most patients stop taking the medications soon after starting them. Depression is mostly dealt with in primary care, but GPs’ assumptions about mental health and its medical management have been inherited from the powerfully vested interests of psychiatry and pharmaceutical companies, while being influenced by financial incentives. Meanwhile, social issues continue to be overlooked in depression management guidelines, in practice, and in society at large; enabling serious engagement with psychosocial determinants of distress to be avoided. A clear-sighted revision of how best to help with patients’ emotional needs is due.