Current Issues of the Treatment Tactics of Family Physician at Patients with Depression (from the Experience of Slovenia and Croatia)

Abstract

In classical family practice with an average number of registered patients up to 2 thousand, the prevalence rate of depression is 5%, moreover, two patients are hospitalized annually due to depression, and one day a patient commits suicide. The goal is to analyze urgent issues of drug therapy for depression and examination of patients within the competence of a primary care physician. According to the WHO, in 2025, depression will be the first cause of disability due to illness according to the DALY indicator (including years lost due to early death and disability). Depression is one of the biggest health problems. The solution to depression is the introduction of good education, appropriate management of depressed patients, as well as realistic expectations from therapy, given that only 20% of patients have only one episode of depression, and 30% of patients do not respond to therapy. A family doctor with his team can manage the treatment of 80% of patients with mild to moderate depression. However, there are situations when you need to turn to specialist – a psychiatrist. In the medical treatment of depressive disorders, three phases are distinguished at the PMC stage: the treatment of an acute depressive episode, the phase of stabilization of the therapeutic effect and the prevention of a new episode of the disease. Treatment most often begins with the appointment of an antidepressant, which in the previous episode or in a close family member showed positive effects.