Diagnosis and Treatment of Depression in General Practice

Abstract

General practitioners (GPs) work in an environment different from that of most of their specialist colleagues. Some of these differences stem from being a doctor of first contact, some from working in one part of a multi-tier system for providing medical care, and some from the referral system which deals with the movement of patients between these tiers. Other differences stem from the GP's National Health Service contract to provide continuity of care 24 hours a day, and to make early diagnoses as well as monitoring normal development on one hand and chronic impairment, handicap, and disability on the other. The British GP works with a defined list of registered patients who can present symptoms representing disorders of a wide range of severity, originating in any bodily system. These symptoms can result from any type of pathogenic stimulus, including disordered perception: even temporary variation from the patient's usual subjective experience may arouse natural concern.