Recommended websites on depression

Websites relating to depression as suggested by Dr Keith Barnard

Website of the week 

It seems many medical professionals and organisations have not seen eye to eye with NICE lately. However, the organisation does present us with some helpful material, such as this quick reference guide to the management of depression in primary and secondary care. Their idea of a quick guide is 16 pages, but the full guidance runs to nearly 70. There are colourful charts and lists, and the stepped care model page is particularly useful. The key priorities list is also worth checking. But it is frustrating to be told that cognitive behavioural therapy is the psychological treatment of choice when it is so seldom available, and interesting that electroconvulsive therapy is still recommended in limited circumstances.

Why go there: an excellent effort from NICE.

Downside: none.

Information from: NICE.

Address: Please click here

Detecting depression

While this website is not spectacular, it does earn its accolade by living up to its title of ‘Mastering Depression in Primary Care’.

It is referred to as an information pack and has been developed to help GPs to recognise and diagnose depression, and provide the tools that make it possible to continuously monitor the patient’s wellbeing and assess outcome of antidepressive treatment.

A two-stage screening procedure is often recommended, using the WHO-Five Well-being Index, and then confirming the diagnosis using the Major (ICD-10) Depression Inventory.

So often such tools are mentioned but you then have to search for them — but here you will find printable versions of these simple scoring systems that can also be downloaded as Word files.

Most importantly, there are basic guides on how to use the questionnaires and interpret the results. The site itself is well-designed with a clear layout and sensible links to various sections.

Why go there: can’t go wrong with this.

Downside: none.

Information from: World Health Organisation.

Address: Please click here

Somatic symptoms and depression

This is a report on a study that acknowledges just how prevalent patients who present with clinical depression are in primary care.

This should help us understand more about physical symptoms in depression and also shows that such symptoms do improve as the depression is treated.

It also emphasises how long the time course of depression is and that patients can also benefit from at least nine months of treatment.

The article is heavy going in places, but if time is short, I suggest you just go to page four and read the discussion, which is really all you need.

Why go there: Relevant to management in primary care.

Downside: Rather a long read.

Information from: Journal of General Internal Medicine.

Address: Please click here

MHRA report

All GPs should be aware of the findings of the Medicines and Healthcare products Regulatory Agency report on the safety of SSRIs.

I make no apology for recommending that you simply read this press release. It is not intended for the medical profession but it contains the key facts.

Here the key points that we must all know are listed, and if you want to have more, the PDF of the report can be downloaded from the reports section of the MHRA website.

Why go there: to make sure you know the key facts.

Downside: simplified version.

Information from: Medicines and Healthcare Products Regulatory Agency

Address:  Please click here

Depression in the elderly

Although this paper is from the US, it carries a message that I believe we might all do well to remember.

It is a lengthy article, but all you need are the abstract and the introduction. The objective of the study was to see whether depression was managed differently in older and younger patients in primary care clinics, and the short answer seems to be ‘yes’.

Younger patients generally appear to get more attention. This is hardly fair on the aged population.

The differences were most marked in what are referred to as the ‘old-old’, meaning people over 75.

No specific reasons for these discrepancies are given, but it is suggested that it might be explained in part by the concept of ‘the invisibility of the ordinary’.

It is definitely worth a read because it provides much food for thought.

Why go there: raises an important issue.

Downside: may not extrapolate exactly to the UK.

Information from: Journal of the American Geriatric Society.

Address: Please click here

Dr Barnard is a former GP in Fareham, Hampshire

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