ABORDAJE NATURAL DE LA DEPRESION EN ATENCION PRIMARIA

La entrevista clínica, centrada en el paciente y su contexto, es la clave para facilitar el diagnóstico y el tratamiento de la depresión y ansiedad en medicina de familia.

Autor:
Benjamín Pérez franco
Columnista Experto de SIIC
Artículos publicados por Benjamín Pérez franco

Coautores
José Luis Turabián Fernández* Iván Pérez Revuelta**
Especialistas en Medicina de Familia y Comunitaria, Ávila, España*
Psicólogo clínico, Ávila, España**

Recepción del artículo
5 de Julio, 2008

Aprobación
28 de Agosto, 2008

Primera edición
21 de Mayo, 2009

Segunda edición, ampliada y corregida
7 de Junio, 2021

ABORDAJE NATURAL DE LA DEPRESION EN ATENCION PRIMARIA

Resumen
En el abordaje ortodoxo de la depresión en medicina de familia existen importantes limitaciones. Tanto la diferenciación entre el origen endógeno y exógeno de la depresión como la discriminación entre las diversas manifestaciones sintomáticas -y por tanto subsíndromes- de la depresión son intrascendentes. Lo mismo ocurre con la discriminación entre ansiedad y depresión en la vida real; así como entre salud física y salud mental, y entre normalidad y depresión. También es intrascendente el uso de tests validados y de la entrevista estructurada para la detección y diagnóstico de la depresión, en comparación con la entrevista clínica narrativa; lo mismo sucede con la aplicación de tecnologías psicoterapéuticas de "marca" en comparación con el desarrollo de una buena alianza terapéutica entre médico y paciente y el conocimiento profundo del paciente por parte del médico. Estas mismas competencias son la mejor guía para saber cuándo instaurar tratamiento farmacológico y cuándo suspenderlo.

Palabras clave
atención primaria, salud mental, depresión, ansiedad, diagnóstico de los trastornos de ansiedad, diagnóstico de los trastornos depresivos, tratamiento de los trastornos de ansiedad, tratamiento de los trastornos depresivos

Artículo completo
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Natural Approach to Depression in Primary Care

Abstract
There are important limitations at depression orthodox approach in Family Medicine. Negligible differentiation among depression endogenous and exogenous origin; negligible discrimination among its diverse symptomatic signs and, therefore, depression's subsyndromes; negligible discrimination among anxiety and depression in real life; negligible discrimination among physical and mental health; negligible discrimination among normalcy and depression; negligible use of validated test and estructured interview for depression diagnosis and identification in comparison with narrative clinic interview; negligible application of "labelled" psychotherapeutic technologies in comparison with the develop of a good therapeutic alliance between physician and patience along with the physician's deeper knowledge of the patience; these very same competencies make up the best guide to know when it's right to apply a pharmalogic treatment and when it's not.

Key words
primary health care/methods, mental health, depression, anxiety, anxiety disorders/diagnosis, depressive disorder/diagnosis, anxiety disorders/therapy, depressive disorder/therapy

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Atención Primaria, Salud Mental
Relacionadas: Geriatría, Medicina Familiar, Medicina Interna

Enviar correspondencia a:
Benjamín Pérez Franco, 05400, C/ Ceubia 36, Arenas de San Pedro, España

Bibliografía del artículo

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