1. The Prevalence and Significance of Depressive Disorders in the Medically Ill Professor Rodolfo Fahrer Copyright © 2011. World Psychiatric Association

2. Depressive Disorders Most frequent condition seen in primary care Large international study found median prevalence rates of more than 10% in this setting Among patients with medical illness, rates are higher: 22 to 33% Depression often comorbid with a variety of medical illnessses. Two strategies to be taken into account: –Increased index of suspicion for depression in medically ill patients. –More intensive antidepressant treatment in depressed patients with medical comorbidity Copyright © 2011. World Psychiatric Association 2

3. Depression and the Immune System Demoralization (feelings of being unable to cope, helplessness, hopelessness and diminished personal esteem) New developments have increasingly put the field of psychoneuroimmunology into a clinical context with important translational implications Depression comorbid with the acute coronary syndrome worsens its progress Copyright © 2011. World Psychiatric Association3

4. Early Detection Depression goes unrecognised in primary care Early identification is important Detection rate can be improved by screening and active investigation Copyright © 2011. World Psychiatric Association4

5. Specific Aims to be Achieved for Successful Results Wide range of strategies to improve mental health and prevent mental disorders Value of continuing medical educational strategies for detection and management of depression in physically ill patients Primary Care Physician should become acquainted with the main groups of antidepressant drugs, leading psychological treatment techniques and principles of social treatment and rehabilitation Copyright © 2011. World Psychiatric Association5

6. About the Trainer The Training Psychiatrist must be adequately trained: Medical identity Training in Psychiatry with a sound basis in psychotherapy Teaching skills allowing for work in a non-specialized medical setting Training seminars for psychiatrist must achieve uniformity in clinical and therapeutic criteria about depression Impart teaching methods and techniques to carry out interviews with colleagues and lead workshops and seminars Copyright © 2011. World Psychiatric Association6