BMJ 2000;320:527-528 ( 26 February )

Editorials

Depression management clinics in general practice?

Some aspects lend themselves to the mini-clinic approach

General practice p   550

The first 150 words of the full text of this article appear below.

In 1979 Stott and Davis identified the four areas of exceptional potential to serve patients in every primary care consultation, which included management of continuing problems along with management of the presenting problem, opportunistic health promotion, and modification of help seeking behaviour.¹ However, we now know that chronic diseases are often more effectively managed through special clinics outside routine consultations, usually staffed by practice nurses. Such "mini-clinics" have been shown to improve the outcome of asthma² and diabetes³ and are now widespread in British general practice, encouraged by separate payments for chronic disease management. Might this approach also be applied to depression?

For many patients depression is more accurately considered a chronic relapsing condition, rather than a series of discrete episodes, and, as for other chronic conditions, there are concerns about how it is managed in routine consultations. Leaving aside issues of recognition and diagnosis, where the evidence base needs improving,⁴ . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Depression management clinics in general practice

Danny Allen
bmj.com, 28 Feb 2000 [Full text]

Concentrating on similarities of disease management

Chris Manning
bmj.com, 13 Mar 2000 [Full text]

Flawed argument

Richard Churchill
bmj.com, 24 Mar 2000 [Full text]

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