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Review
. 2017 Aug;58(8):459-466.
doi: 10.11622/smedj.2017080.

Managing depression in primary care

Chung Wai Mark Ng  1 , Choon How How  2 , Yin Ping Ng  3   4
Affiliations
Review

Managing depression in primary care

Chung Wai Mark Ng et al. Singapore Med J. 2017 Aug.

Abstract

Major depression is common in the primary care setting. In the final article of this series, we illustrate the approach to the management of depression in primary care. Psychotherapy has been shown to be as effective as antidepressants for mild to moderate major depression. The common myth that antidepressants are addictive should be addressed. Antidepressants should be started at a subtherapeutic dose to assess tolerability, then gradually increased until a minimally effective dose is achieved. Apart from pharmacotherapy and psychotherapy, management of depression should include managing stressors, engaging social and community support, dealing with stigma and discrimination, and managing concomitant comorbidities. A strong therapeutic relationship and empathic listening are important between the primary care physician and patient.

Keywords: antidepressants; depression; primary care.

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Figures

Fig. 1
Fig. 1
Flowchart shows approach to the treatment of depression in primary care.
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: 2013.
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