Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor and Online Editor, JAMA.
Author Affiliation: Dr Whooley is Professor of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, and Staff Physician, Department of Veterans Affairs Medical Center, San Francisco.
Approximately 1 in 10 primary care patients has major depressive disorder, and its presence is associated with poor health outcomes in numerous medical conditions. Using the case of Mr J, a 52-year-old man with depressive symptoms and several comorbid medical conditions, diagnosis and treatment of depression are discussed. Specific topics include evidence regarding appropriate depression screening and diagnosis, the importance of team-based care, patient self-management, exercise, structured psychotherapy, pharmacotherapy, monitoring of therapy, and indications for referral.
Whooley MA. Diagnosis and Treatment of Depression in Adults With Comorbid Medical ConditionsA 52-Year-Old Man With Depression. JAMA. 2012;307(17):1848–1857. doi:10.1001/jama.2012.3466