10/2/17 ¨ I have no disclosures. Debra Poole, PA-C, MPAS October 11, 2017
[email protected] ¨ Improve readiness and efficacy in Primary Care treatment of depression and anxiety ¨ Gain Awareness of: ¡ Prevalence ¡ Screening tools ¡ Treatment options: Pharmacological and nonpharmacological ¡ STAR*D ¡ Genetic testing and other labs ¡ Comorbidities 1 10/2/17 ¨ Depression is the world's fourth most prevalent ¨ Arthritis health problem causing US $30-$50 billion per year ¨ Diabetes in lost productivity and direct medical costs. ¨ Stroke ¨ PCPs are the sole contact for more than 50% of patients with mental illness. ¨ Obesity ¨ Symptoms consistent with depression are present ¨ Substance Use Disorder in nearly 70% of patients who visit a PCP. ¨ GAD is one of the most common mental disorders in primary care settings with a lifetime prevalence of 5-12% in the US. ¨ Headache, migraines ¨ Mary, a 51 year old, married Caucasian female ¨ Sexual dysfunction arrives early to her appointment complaining ¨ Appetite changes of joint pain. Later in the interview she reports ¨ Menstrual-related symptoms that she has a bad case of the “Don’t Wannas” ¨ Chronic pain and rarely leaves her house these days. She doesn’t really see any purpose in her life any ¨ Chronic medical conditions (eg, diabetes, Parkinson's disease, alcoholism) longer but denies SI. She insists that she isn’t depressed. “I’m not sad.” ¨ Digestive problems (eg, diarrhea, constipation) ¨ Fatigue ¨ Sleep disturbances 2 10/2/17 A. Keep from rolling your eyes as you dismiss her complaints by telling her “There, there it will be ok.” B. Refer her to psych, pronto! C.