El médico general como primer contacto en usuarios con depresión e ideación suicida

Abstract

The National Psychiatric Epidemiology Survey conducted in Mexico (2003), showed that prevalence of depression in adults in the last year, was of 4.5%. By gender, the authors state that Medical coverage for depressive events according with the obtained data, more than 2 500 000 women (older than 18), reported depressive episodes in the last year, of which only 27.2% were ever diagnosed as depressive by a physician, and 7.9% were prescribed for antidepressant drugs in the last two weeks. Among men, more than 800 000 (older than 18) had suffered depression. In this case, percentage of participants with a medical diagnose was of 19, and 6.1 prescribed. Preliminary diagnosis is more frequent among subjects who belong to a social security service. Thus, 37.4% of insured women with depression symptoms had been diagnosed, versus 21% of not insured. Also, 28.9% of insured men had been diagnosed against 14% of not insured. The authors mention that it is quite common that people with affective disorders attend early to physicians, although their condition is not efficiently attended due their lack of domain for accurate diagnosis and appropriate treatment. In the present research, the Beck Depression Inventory in its Mexican version (Jurado, et al., 1998), and the Suicide Orientation Inventory (Casullo 2003), were applied to a sample (N=151) of people demanding Medical or Psychological service at the school clinic of the FESI, UNAM. Results showed that the major level of depression was the Mild one, which determines its population as the one in risk to
develop a severe condition. This finding ratified the fact
that waiting for an adequate professional care based on a waiting list, is not the suitable manner to provide it. About suicidal ideation, prevalence demonstrated that most of the sample reported high (36%) or serious (39.2%) levels. Another important finding concerning the Low level of depression, 5.34% of the sample asked for Medical care as the first option, when the initial symptoms emerge. Although 7.63% went to Psychology service for the first attempt, preference of initial professional care is not quite different between Medical or Psychological services; hence, it is quite important that physicians improve other mechanisms in order to provide an effective and appropriate diagnosis and treatment to approach mental disorders in a multidisciplinary practice.