PORTAL FOR LIFELONG LEARNING IN PSYCHOPATHOLOGY

HELLENIC PSYCHIATRIC ASSOCIATION CLINICAL WORKSHOP

Coordinator:

Dimitris Ploumpidis

Professor of Psychiatry, Chairman of the Hellenic Psychiatry Association

Trainers:

George Konstantakopoulos

Psychiatrist, MD, PhD

Scientific associate of the First Department of Psychiatry of the University of Athens & Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK

Nikoleta Ioannidi

Clinical psychologist, MSc

Scientific associate of the First Department of Psychiatry of the University of Athens

Duration: 3 hours

Aim - Subjects:

Depression and anxiety disorders are the most common diseases in economically developed countries and the dysfunction they cause to patients is extremely important. It is estimated that in 2030, depression will be the main cause of disability worldwide. In addition, depressive and anxiety disorders often accompany a variety of physical illnesses the development and prognosis of which are significantly affected by it.

A large number of patients with mental disorders are increasingly using health services regardless of the co-existence or absence of physical illnesses. In particular, depression is the third most common cause, among both physical and mental illnesses, for seeking primary health care services. Patients with depression are estimated to reach out to doctors of specialties other than psychiatry by a rate of 70-80%. However, according to relevant studies, the identification rates of depression and anxiety in Primary Health Care settings are particularly low (36-56% and 15-36%, respectively). As a result, about half of the patients suffering from depressive and anxiety disorders remain undiagnosed and therefore untreated.

This clinical workshop focuses on addressing this major issue of public health. The ability to diagnose and treat depression within the context of Primary Health Care must be reinforced. Primary care physicians must be appropriately trained in order to be able to diagnose and treat depression, while distinguishing the cases they must refer to an expert. Appropriate methods and tools in order to facilitate primary care physicians in this task have been developed in recent years in many countries with well-organized health systems. This clinical workshop is part of an effort to develop a specific methodology and to provide appropriate training for physicians in our country as well.

The clinical workshop is addressed to general practitioners and doctors of specialties other than psychiatry who work in Primary Health Care services.

The purpose of the Clinical Workshop is to adequately train primary health care physicians in order for them to be able to diagnose and treat depression, while distinguishing the cases that they must refer to an expert. Participants will familiarize with methods and tools that facilitate primary care physicians in this task.

In particular, the reinforcement of primary care physicians will be pursued in the clinical workshop through the following means:

• Provision of basic knowledge on the epidemiology, clinical manifestation and prognosis of depression
• Training in brief mode of detection of depression by identifying risk factors and addressing only two questions to the patient
• Presentation of a method for the diagnosis, clinical assessment and therapeutic planning of depression
• Training in the use of a short questionnaire for the diagnosis and monitoring of depression (PHQ-9) and of a short questionnaire for the assessment and monitoring of anxiety (GAD-7)
• Short training in treatment, monitoring of therapeutic response and management of medication
• Presentation of special printed Guides

TRAINING PROGRAM

1st part: INTRODUCTION

Α) Depression: Epidemiological data and consequences:

1. B) The Issue: Detection - Diagnosis and Treatment in Primary Health Care
2. C) Clinical manifestations, clinical types and prognosis of depression

2nd part: DETECTION AND DIAGNOSIS OF DEPRESSION IN PRIMARY HEALTH CARE

Α) The patient with depression in Primary Health Care: “Red Flags”:

1. B) A brief mode of detection of depression
2. C) Diagnosis and clinical assessment with the use of PHQ-9.
3. D) Training in detection and diagnosis (vignettes - discussion)

3rd part: ADDITIONAL KNOWLEDGE FOR DIAGNOSIS AND CLINICAL ASSESSMENT

Α) Differential Diagnosis - Useful tools

Β) Suicidal risk assessment

1. C) Assessment of concurrent anxiety with the use of GAD-7
2. D) Training in suicidal risk and anxiety assessment (vignettes - discussion)

4th part: TREATMENT OF DEPRESSION IN PRIMARY HEALTH CARE

Α) Therapeutic options

Β) Antidepressant medication

1. C) Assessment of the therapeutic response with the use of PHQ-9 and GAD-7
2. D) Strategies for handling difficulties - management of pharmaceutical treatment
3. E) Therapeutic goals – maintenance therapy
4. F) Training in patient follow-up (vignettes - discussion)

“Clinical workshops during the years 2015 and 2016 were provided free of charge within the context of a program of the Hellenic Psychiatric Association, which was implemented with the sponsorship of MYLAN.”