HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wagenaar, D. B. Search for Related Content PubMed Articles by Wagenaar, D. B.

Dr Wagenaar is an associate professor and geriatric psychiatrist in the Department of Psychiatry at Michigan State University in East Lansing.

E-mail: wagenaar{at}msu.edu.

Doctor my nerves are bad!" is the complaint of many of our primary care patients. But how can physicians bolster their skills to aggressively identify depression and anxiety in such patients, and what do we do once we have identified these problems?

This supplement to JAOA—The Journal of the American Osteopathic Association provides two leading articles crafted to assist primary care physicians in accurately recognizing depression and anxiety in medically ill patients, as well as to help them understand available treatment options. These articles are based on the content of the symposium titled "Strategies for Identifying and Treating Anxiety, Depression, and Medical Comorbidities," which the American College of Osteopathic Family Physicians held on October 25, 2005, during the Unified Osteopathic Convention in Orlando, Fla.

Evidenced-based medicine provides initial guidance for the research reflected in these presentations. Douglas R. Dolnak, DO, reviews transmitter function and neurobiology with helpful information about the relationship between neurotransmitter systems, brain structure, and clinical symptoms. In addition, Dr Dolnak offers an overview of clinical trials data offering solid evidence that antidepressants and psychotherapy can effectively reduce or eliminate the symptoms of depression and anxiety.

Yemi Aina, MD, and Jeffrey L. Susman, MD, take a practical approach to the problem by emphasizing the interface of medical illness and psychiatric symptoms. They remind physicians to consider reversible causes for anxiety and depression as well as point out just how common these conditions are in patients with heart disease, human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS), and diabetes mellitus.

What are the "take home" messages of this supplement? First, evidence-based medicine suggests that depression and anxiety often coexist in our patients and are difficult at times to tease apart. Although depression and anxiety are associated with medical illness, they should not be considered merely reactive or situation based. Second, clinical trials research clearly suggests that these conditions are treatable with antidepressants and psychotherapy. This is hopeful news for many patients. Depression treatment should be aggressive to ward off the symptomatic, functional, economic, and quality-of-life problems that result from untreated or undertreated illness. Finally, we must maintain a high index of suspicion for both of these disorders in the patients we see every day.

	Footnotes

 
Dr Wagenaar has no conflicts of interest to disclose.

This continuing medical education publication is supported by an unrestricted educational grant from Forest Laboratories, Inc.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wagenaar, D. B. Search for Related Content PubMed Articles by Wagenaar, D. B.