eISSN: 2449-8580
ISSN: 1734-3402
Family Medicine & Primary Care Review
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3/2017
vol. 19
 
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abstract:

Guidelines of the Polish Psychiatric Association – Wroclaw Division, the Polish Society of Family Medicine and the College of Family Physicians in Poland for diagnosis and treatment of depressive disorders in primary health care

Patryk Piotrowski
1, 2
,
Tomasz Maciej Gondek
1, 2, 3
,
Joanna Rymaszewska
1, 2
,
Jan Aleksander Beszłej
1, 2
,
Sławomir Czachowski
4, 5
,
Henk Parmentier
6, 7
,
Donata Kurpas
2, 8, 9

  1. Department of Psychiatry, Wroclaw Medical University, Poland
  2. Polish Psychiatric Association – Wroclaw Division, Poland
  3. Specialty Training Section, Polish Psychiatric Association, Poland
  4. Department of Clinical Psychology, Nicolaus Copernicus University in Torun, Poland
  5. College of Family Physicians in Poland
  6. Medical School, Nova University, Lisbon, Portugal
  7. WONCA Working Party on Mental Health
  8. Family Medicine Department, Wroclaw Medical University, Poland
  9. Polish Society of Family Medicine, Poland
Family Medicine & Primary Care Review 2017; 19(3): 335–346
DOI: https://doi.org/10.5114/fmpcr.2017.69300
Online publish date: 2017/09/22
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Mental disorders are common among patients seen by primary care physicians. T he most common ones are: mood disorders, anxiety disorders and somatic disorders. Psychological problems often coexist with somatic illnesses, negatively affecting their natural course, adherence to medicines and treatment, and thus the effectiveness of treatment. A part from biological determinants, such as genetic load, somatic disease burden and treatment options, depressive disorders are also linked to socio-demographic factors.

The multitude of issues that require attention from the physician during routine medical consultations makes it difficult to diagnose and decide on appropriate treatment. Screening tools with proven psychometric parameters can facilitate this process. Most patients

with unipolar mood disorders can be treated within the primary care setting. They are seeking help from their well-known family physicians and often do not require a psychiatric consultation. I t should be emphasized that the vast majority of primary care patients report

symptoms of psychosomatic disorders that are aggravated by daily stressful situations. Before starting diagnostic and therapeutic actions, it is advisable to extend the consultation time, analyze their family, financial and professional situation and convince them to use stress management techniques, as well as to persuade them to change perception of the environment and avoid negative habits in life and nutrition. I f there is no improvement of the depressive symptoms after 2 to 4 weeks, other therapeutic strategies should be considered. I n this paper, the authors propose simplified regimens and indicate the possibilities and limitations of the treatment of mental health disorders in the primary health care setting.
keywords:

primary health care, depression, mood disorders, antidepressant treatment

  
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