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RECOGNITION AND TREATMEN OF DEPRESSION IN PRIMARY CARE: RUSSIAN EXPERIENCE

RECOGNITION AND TREATMEN OF DEPRESSION IN PRIMARY CARE: RUSSIAN EXPERIENCE. V.N.Krasnov,T.V.Dovjenko, N.V.Yaltseva at al. Moscow Research Institute of Psychiatry. Table 1. Table 2. Table 3. Table 4. Table 5. Table 6.

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RECOGNITION AND TREATMEN OF DEPRESSION IN PRIMARY CARE: RUSSIAN EXPERIENCE

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  1. RECOGNITION AND TREATMEN OF DEPRESSION IN PRIMARY CARE: RUSSIAN EXPERIENCE V.N.Krasnov,T.V.Dovjenko, N.V.Yaltseva at al. Moscow Research Institute of Psychiatry

  2. Table 1

  3. Table 2

  4. Table 3

  5. Table 4

  6. Table 5

  7. Table 6 RECOMMENDATIONS ON QUESTIONNAIRESASSESSMENTPatients are selected for further clinical examination whose answers include the following: • Positive responses to not less then three items, • Positive responses to items 4 and 5 simultaneously, • Positive responses to item 6 (alone or in any combination), • Positive responses to item 7 (alone or in any combination).

  8. Depressed mood (irrespective from the situation) Lack of interest or pleasure Lack of energy and fatigue Poor concetration Loss of confidence or self-esteem Guilt or self-reproach Bleak and pessimistic views of the future Recurrent suicidal thoughts or thoughts about self-destruction Sleep disturbances of any type Disturbed appetite (along with weight changes) Table 7 ICD-10 CRITERIA OF DEPRESSIVE EPISODE Diagnostic features Associated symptoms 2 or 3 symptoms should be presented obligatory 2-4 symptoms should be associated with obligatory symptoms Symptoms should be last for at least two weeks

  9. Fig. 1 PATIENTS OF PRIMARY CARE SETTINGSn=6785

  10. Fig. 2 AFFECTIVE SPECTRUM DISORDERSACCORDING TO THE SCREENING RESULTS AGE DISTRIBUTION 56  n=2537  55years n=4248

  11. Fig. 3 AFFECTIVE SPECTRUM DISORDERSIN PATIENTS UNDER 55 ACCORDING TO THE SCREENING RESULTS GENDER DISTRIBUTION Male n=1222 Female n=3026

  12. Fig. 4 CLINICAL DEPRESSION IN PATIENTS UNDER 55ACCORDING TO THE ICD-10 CRITERIAGENDER DISTRIBUTION Male n=1222 Female n=3026

  13. Fig. 5 DIAGNOSTICS AND THERAPY OF DEPRESSION IN OUT-PATIENTS (aged 18-55 years old) 4248 out-patients of PC settings were screened (special screening questionnaire was used) Nurse/General practitioner Affective spectrum disorders have been recognized in 2286 ( 53,8%) of patients General practitioner 1629 ( 38,3% ) of the patients were observed by psychiatrist Psychiatrist Psychiatrist in 1380 ( 32,5%) of the patients depression has been recognized Psychiatrist/ General practitioner 1145 ( 26,9%) were advised to have treatment with antidepressants (HAM-D score  15) Psychiatrist/ General practitioner/ Nurse 976 (22,9%) have completed the 4-weeks course of treatment

  14. Fig. 6 RESULTS OF FLUOXETINE THERAPY OF DEPRESSION IN OUTPATIENTSn=204 19.4±2.7 * - p<0.001 * 7.9±1.3 * 4.0±0.8

  15. Fig. 7 RESULTS OF TIANEPTINE THERAPY OF DEPRESSION IN OUTPATIENTSn=269 19.6±2.5 * - p<0.001 * 8.1±1.4 * 4.1±0.9

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