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British Journal of General Practice

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Clinical Intelligence

An evidence-based first consultation for depression: nine key messages

Bruce Arroll, Weng Yee Chin, Fiona Moir and Christopher Dowrick
British Journal of General Practice 2018; 68 (669): 200-201. DOI: https://doi.org/10.3399/bjgp18X695681
Bruce Arroll
Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
Roles: Professor
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Weng Yee Chin
Department of Family Medicine and Primary Care, Bau Institute of Medical and Health Sciences Education, University of Hong Kong, Hong Kong.
Roles: Assistant professor
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Fiona Moir
Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
Roles: Senior lecturer
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Christopher Dowrick
University of Liverpool, Liverpool, UK.
Roles: Professor of primary medical care
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Article Information

vol. 68 no. 669 200-201
DOI 
https://doi.org/10.3399/bjgp18X695681
PubMed 
29592945

Published By 
Royal College of General Practitioners
Print ISSN 
0960-1643
Online ISSN 
1478-5242
History 
  • Received September 25, 2017
  • Revision requested October 30, 2017
  • Accepted November 3, 2017
  • Published online March 28, 2018.

Copyright & Usage 
© British Journal of General Practice 2018

Author Information

  1. Bruce Arroll, PhD, FRNZCGP (Distinguished), Professor
  1. Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
  1. Weng Yee Chin, MD FRACGP, Assistant professor
  1. Department of Family Medicine and Primary Care, Bau Institute of Medical and Health Sciences Education, University of Hong Kong, Hong Kong.
  1. Fiona Moir, PhD, Senior lecturer
  1. Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
  1. Christopher Dowrick, BA, MSc, MD, FRCGP, Professor of primary medical care
  1. University of Liverpool, Liverpool, UK.
  1. Address for correspondence
    Bruce Arroll, University of Auckland, Department of General Practice and Primary Health Care, School of Population Health, the University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. Email: bruce.arroll{at}auckland.ac.nz
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British Journal of General Practice: 68 (669)
British Journal of General Practice
Vol. 68, Issue 669
April 2018
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An evidence-based first consultation for depression: nine key messages
Bruce Arroll, Weng Yee Chin, Fiona Moir, Christopher Dowrick
British Journal of General Practice 2018; 68 (669): 200-201. DOI: 10.3399/bjgp18X695681

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An evidence-based first consultation for depression: nine key messages
Bruce Arroll, Weng Yee Chin, Fiona Moir, Christopher Dowrick
British Journal of General Practice 2018; 68 (669): 200-201. DOI: 10.3399/bjgp18X695681
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    • 1. DEPRESSION IS COMMON IN PRIMARY CARE BUT MANY PATIENTS MAY NOT RECEIVE A MENTAL HEALTH DIAGNOSIS
    • 2. HOW IMPORTANT IS IT TO HAVE A DIAGNOSIS OF DEPRESSION OR ANXIETY VERSUS ‘BEING HEARD AND UNDERSTOOD’?
    • 3. DIFFERENTIATING PSYCHOLOGICAL DISTRESS FROM DEPRESSION CAN BE VERY CHALLENGING, PARTICULARLY ON THE FIRST VISIT
    • 4. MOST PATIENTS WITH DEPRESSION PRESENT WITH SOMATIC SYMPTOMS, SO OPEN THE CONSULTATION BY INCLUDING MENTAL ALONGSIDE PHYSICAL HEALTH
    • 5. RULE OUT DEPRESSION BY USING TWO QUESTIONS AND EXPLORE FURTHER IF THERE IS A POSITIVE RESPONSE
    • 6. ONE-OFF HIGH DEPRESSION SCORES DO NOT NECESSARILY SIGNIFY MAJOR DEPRESSION AND ARE LIKELY TO BE LOWER AT THE NEXT VISIT
    • 7. CONSIDER NON-DRUG INTERVENTIONS FIRST
    • 8. THINK VERY CAREFULLY BEFORE COMMENCING ANTIDEPRESSANT MEDICATION ON THE FIRST VISIT
    • 9. SEE THE PATIENT AGAIN IN 1 WEEK (IF POSSIBLE) AND CONSIDER PHONING THEM BETWEEN VISITS
    • Acknowledgments
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Print ISSN: 0960-1643
Online ISSN: 1478-5242