Identification of Common Mental Disorders and Management of Depression in Primary Care

Contents......Page 7
Recommendations and good practice points......Page 9
3 Recognition and assessment of common mental disorders in young people/rangatahi/tamariki......Page 49
3.8	Determining severity and when to refer......Page 65
4 Management of depression in young people/rangatahi/tamariki......Page 69
5 Recognition and assessment of common mental disorders in adults/pakeke......Page 81
5.6	Determining severity and when to refer......Page 90
6 Management of depression in adults/pakeke......Page 93
7 Special issues: women with mental disorders in the antenatal and postnatal period......Page 117
8 Special issues: older adults/koroua/kuia......Page 135
List of boxes......Page 10
When to refer a young person/rangatahi/tamariki to secondary care mental health services......Page 67
Lifetime prevalence of common mental disorders in New Zealand adults......Page 31
Prevalence of common mental disorders in children and adolescents......Page 34
1.4	Etiology of common mental disorders......Page 36
HEEADSSS......Page 53
HEARTS......Page 54
Explaining the limits of confidentiality......Page 55
CRAFFT......Page 59
Whänau Ora......Page 72
Screening for common mental disorders in primary care......Page 84
Verbal 2–3 question screening tools for common mental disorders......Page 86
5.4	Assessment tools: evidence review......Page 87
5.7	From assessment to management......Page 92
Selective serotonin reuptake inhibitors......Page 101
Information for patients on antidepressants and their family/whänau......Page 102
Response to treatment......Page 103
First-generation and second-generation antidepressants......Page 112
Purpose......Page 11
About the guideline......Page 13
Key messages......Page 21
Algorithms 1–5......Page 22
1.1	Primary care challenges......Page 27
1.2	Cultural perspectives......Page 28
1.3	Epidemiology of common mental disorders......Page 30
1.5	Special issues......Page 38
2.2	Recognising potential mental disorders......Page 43
2.4	Practitioner roles......Page 44
2.5	Managing depression: shared decision-making......Page 45
2.7	Culturally competent care......Page 46
3.1	Applying strengths-based and biomedical models......Page 50
3.2	Screening young people/rangatahi/tamariki for common mental disorders......Page 51
3.3	Psychosocial assessment of young people/ rangatahi/tamariki......Page 52
3.4	Further assessment where there is concern......Page 56
3.5	Assessment tools: evidence review......Page 57
3.6	Clinical features of common mental disorders in young people/rangatahi/tamariki......Page 60
3.7	Reaching a diagnosis......Page 64
3.9	From assessment to management......Page 66
4.1	Clinical management......Page 71
4.2	Specific interventions: review of the evidence......Page 75
5.1	Psychosocial assessment of adults/pakeke......Page 82
5.2	Targeted screening of high-risk groups......Page 83
5.3	Further assessment where there is concern......Page 85
5.5	Reaching a diagnosis......Page 89
6.1	Clinical management......Page 95
6.2	Prevention of relapse or recurrence......Page 105
6.3	Specific interventions: evidence review......Page 106
7.1	Mental disorders in the antenatal and postnatal period......Page 119
7.2	Screening of women in the antenatal and postnatal period......Page 120
7.3	Screening and assessment tools: evidence review......Page 121
7.4	Further assessment where there is concern......Page 123
7.5	Management of antenatal and postnatal depression......Page 124
7.6	Specific interventions: evidence review......Page 129
8.2	Assessment tools for older adults: evidence review......Page 137
8.3	Assessing an older adult with cognitive impairment......Page 138
8.4	Management of depression......Page 139
8.5	Interventions for depression in older adults/koroua/kuia: evidence review......Page 141
8.6	Depression with dementia......Page 142
9.2	Generic models: evidence review......Page 145
9.3	Service delivery: special issues for young people......Page 147
9.4	Service delivery: special issues for Mäori......Page 148
9.5	Service delivery: special issues for pacific peoples......Page 150
10.2 Potential implementation activities......Page 153
Appendices......Page 157
Appendix A: Guideline development process......Page 158
Appendix B: Evidence and recommendation grading system......Page 160
Appendix C: Assessment of suicide risk......Page 162
Appendix D: Assessment tools for common mental disorders......Page 164
Appendix E: Management of common mental disorders other than depression in young people......Page 165
Appendix F: Self-management resources......Page 168
Appendix G: Management of common mental disorders other than depression in adults......Page 171
Appendix H: Assessing for cognitive impairment in older adults......Page 173
Glossary, abbreviations and acronyms......Page 175
References......Page 181