ABSTRACT
Treatment of depression is based on comprehensive diagnostic, clinical and psychosocial evaluation. Brief psychotherapies (cognitive, interpersonal, psychodynamic or problem-solving) are effective in mild to moderate depression; antidepressants in mild to severe, and electroconvulsive therapy in severe or psychotic. Combining antidepressants and psychotherapy is more effective than either alone. After the acute phase, antidepressants should be continued for six months to prevent relapses, and maintenance treatment considered after three lifetime episodes. Primary care is responsible for treatment of mild to moderate depressions; developing psychiatric consultation services and use of nurse case managers are recommended.
Subject(s)
Depression/therapy , Antidepressive Agents/therapeutic use , Combined Modality Therapy , Electroconvulsive Therapy , Humans , Primary Health Care , Psychotherapy , Recurrence , Time FactorsABSTRACT
The treatment of depression is based on careful diagnostic evaluation. In the acute phase of treatment, brief psychotherapies (cognitive, interpersonal, psychodynamic or problem-solving) are effective in cases of mild to moderate depression. Antidepressants are also effective, their importance increasing alongside the level of severity. Electroconvulsive therapy (ECT) is effective for severe or psychotic depression. After the acute phase, antidepressants must be continued for at least six months to prevent a relapse; maintenance antidepressant treatment must be considered after three lifetime episodes. Primary health care is responsible for the majority of mild to moderate cases of depression, but psychiatric consultation services and nurse case managers are required to fulfill this task.