Algorithm of management of patients with depression in primary medical practice (from the experience of Slovenia and Croatia).

Prof. Babinets L.S.

Ternopil National Medical University named I. Ya. Gorbachevsky of the Ministry of Health of Ukraine.

Relevance. Depression is one of the most significant problems of public health and society as a whole. Depressive episodes often begin after a negative life event, and they are often diagnosed in family medicine.The goal is to analyze the main key aspects of managing a patient with depression in primary care practice based on a real clinical situation.Main part. The most important risk factors for depression are early episodes of depression, depressive problems in close relatives, the female gender, the age of 18 to 30 years, as well as the average age, concomitant chronic physical illness, low socioeconomic status, divorce, widowhood or loneliness, unemployment, abuse of alcohol and illegal substances. In patients who have started taking antidepressants and who are not at risk of suicide, it is planned: 1) two weeks for further observation, 2) after that regular monitoring every two to four weeks during the first three months of taking the drugs, 3) if the therapeutic effect of antidepressants is satisfactory, intervals between observations may be longer. Depressed patients who have residual symptoms after treatment need an assessment of their performance to resolve the issue of the possibility of doing the work they did before.Returning to work largely depends on the patient’s motivation, which, in turn, depends on his satisfaction, physical working conditions, remuneration, social conditions, relations with the employer, colleagues and the degree of creativity in the work, which makes it a challenge and allows for self-realization.Conclusion: Current practice of primary care shows that in Croatia and Slovenia up to 50%, and in the UK up to 80% of patients with depression are diagnosed, treated and followed up at the stage of primary care. In organizing a management plan for patients with depression, the family doctor determines the treatment and follow-up. Evaluation of permanent disability is possible only after completion of treatment and rehabilitation, if it is concluded that the patient’s health cannot be significantly improved.

Key Words: depression, clinical case, antidepressants, assessment of disability, indications for hospitalization.