TY - JOUR
KW - Antidepressive Agents/therapeutic use
KW - Anxiety/complications
KW - Behavioral Sciences
KW - Depression
KW - Depressive Disorder, Major/complications/drug therapy
KW - Evidence-Based Medicine
KW - Fatigue/complications
KW - Humans
KW - Medical Decision Making
KW - Pain/complications
KW - Patient-Centered Care
KW - pharmacotherapy
KW - Primary Health Care
KW - Sleep Initiation and Maintenance Disorders/complications
AU - S . Y. Lin
AU - M. B. Stevens
A1 - 
AB - Unipolar major depressive disorder is a common, disabling, and costly disease that is the leading cause of ill health, early death, and suicide in the United States. Primary care doctors, in particular family physicians, are the first responders in this silent epidemic. Although more than a dozen different antidepressants in 7 distinct classes are widely used to treat depression in primary care, there is no evidence that one drug is superior to another. Comparative effectiveness studies have produced mixed results, and no specialty organization has published recommendations on how to choose antidepressants in a rational, evidence-based manner. In this article we present the theory and evidence for an individualized, patient-centered treatment model for major depression designed around a targeted symptom cluster-based approach to antidepressant selection. When using this model for healthy adults with major depressive disorder, the choice of antidepressants should be guided by the presence of 1 of 4 common symptom clusters: anxiety, fatigue, insomnia, and pain. This model was built to foster future research, provide a logical framework for teaching residents how to select antidepressants, and equip primary care doctors with a structured treatment strategy to deliver optimal patient-centered care in the management of a debilitating disease: major depressive disorder.
BT - Journal of the American Board of Family Medicine : JABFM
C5 - General Literature
CP - 1
CY - United States
DO - 10.3122/jabfm.2014.01.130145
IS - 1
JF - Journal of the American Board of Family Medicine : JABFM
N2 - Unipolar major depressive disorder is a common, disabling, and costly disease that is the leading cause of ill health, early death, and suicide in the United States. Primary care doctors, in particular family physicians, are the first responders in this silent epidemic. Although more than a dozen different antidepressants in 7 distinct classes are widely used to treat depression in primary care, there is no evidence that one drug is superior to another. Comparative effectiveness studies have produced mixed results, and no specialty organization has published recommendations on how to choose antidepressants in a rational, evidence-based manner. In this article we present the theory and evidence for an individualized, patient-centered treatment model for major depression designed around a targeted symptom cluster-based approach to antidepressant selection. When using this model for healthy adults with major depressive disorder, the choice of antidepressants should be guided by the presence of 1 of 4 common symptom clusters: anxiety, fatigue, insomnia, and pain. This model was built to foster future research, provide a logical framework for teaching residents how to select antidepressants, and equip primary care doctors with a structured treatment strategy to deliver optimal patient-centered care in the management of a debilitating disease: major depressive disorder.
PP - United States
PY - 2014
SN - 1557-2625; 1557-2625
SP - 151
EP - 159
EP - 
T1 - The symptom cluster-based approach to individualize patient-centered treatment for major depression
T2 - Journal of the American Board of Family Medicine : JABFM
TI - The symptom cluster-based approach to individualize patient-centered treatment for major depression
U1 - General Literature
U2 - 24390897
U3 - 10.3122/jabfm.2014.01.130145
VL - 27
VO - 1557-2625; 1557-2625
Y1 - 2014
ER -