الفهرس 
Introduction & RationaleOnly 14 pages are availabe for public view
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Abstract
Depression is a medical disorder commonly seen in primary care. Effective treatment of depression requires a compassionate approach, skillful care, long-term follow up, and sometimes, active pharmacotherapy. Bolstered by a positive attitude toward its diagnosis and management, effective communication skills, and appropriate expert backup, the primary care practitioner can feel confident in the assessment and management of this highly treatable disorder.
Major depression is a potentially chronic and recurrent illness with lifetime prevalence. Dysthymic disorder (chronic depression) and other subthreshold depressive disorders (minor depression) further increase these prevalence.
Depressive disorders are associated with excessive utilization of medical services, marked morbidity, staggering economic costs, and significant mortality from suicide as well as from comorbid medical illnesses. Despite a tendency to explain away the presence of depressive symptoms as an expected consequence of life stresses or physical illnesses, major depression should be viewed as a serious complication of such circumstances warranting aggressive intervention.
More individuals suffering from mental disorders receive their care from primary carephysicians than from psychiatrists or other mental health professionals. Depression is probably the most common mental disorder in primary care practice, because depressed patients in primary care settings commonly present with somatic symptoms rather than complaints of depressed mood, clinicians must be proficient in the assessment and management of depression. The skillful differential diagnosis of depressive symptoms is essential because major depression commonly presents as an associated problem in patients with other