Dépression en médecine générale

Abstract

Identification of Major Depressive Disorder (MDD) can be easily done by asking systematically the following questions. During the last month: "Did you lose interest and pleasure for the things that you usually like and enjoy?" "Have you lost energy, or do you feel abnormally tired or depressed?" Physical symptoms of MDD are more frequent for patients supported by general practitioner. Patients suffering from a general medical affection are more likely to present a risk of MDD. Treatment of MDD for patients suffering from a general medical affection must be identical to that of patients not suffering from a medical affection. Objective of the antidepressant treatment is the complete remission and not only the response. Evaluating precisely the symptoms of depression in pretherapetical phase allows to facilitate distinction of side effects of a treatment versus residual symptoms of depression. Treatment must be taken during a sufficient period: 6to 9months for a first Major depressive episode up to entire life for the most serious cases of recurrent MDD. Making the patient aware of the main side effects of the treatment that he will face rapidly (digestion troubles essentially) is a simple way to reduce the risks of early abandon of the treatment.