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3 - Management of late-life depression in primary care: case studies UK

Published online by Cambridge University Press:  18 December 2009

Carolyn A. Chew-Graham ,
Robert Baldwin  and
Alistair Burns
By
Ceri Dornan ,
Helen Pusey ,
Christopher Dowrick ,
Sue Martin ,
Ruth Thompson  and
Michael Morley
Carolyn A. Chew-Graham
Affiliation:
University of Manchester
Robert Baldwin
Affiliation:
Manchester Mental Health and Social Care NHS Trust
Alistair Burns
Affiliation:
University of Manchester
Ceri Dornan
Affiliation:
General Practitioner and GP with Special Interest (Mental Health), Manchester Primary Care Trust
Helen Pusey
Affiliation:
Lecturer in Nursing University of Manchester
Christopher Dowrick
Affiliation:
General Practitioner and Professor of Primary Care, University of Liverpool
Sue Martin
Affiliation:
Independent Practitioner and Trainer Liverpool
Ruth Thompson
Affiliation:
General Practitioner Manchester
Michael Morley
Affiliation:
Consultant Clinical Psychologist, Manchester Mental Health and Social Care Trust
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Summary

In order to illustrate the integrated management of depression in older people in UK primary care, we asked contributors to provide commentaries on a selection of cases drawn from real-life scenarios. The following three chapters contain these commentaries together with a summary by the editors. The first three cases illustrate the management of patients with mild to moderate depressive symptoms in primary care.

A request for sleeping tablets

Mr Seth Y, aged 69 years, presents to his GP complaining that he can't sleep. He admits to feeling upset and worried, although he doesn't know why. He denies that anything has recently happened to him, but the practice receptionist is aware that his son and family have emigrated to New Zealand, and both Mr and Mrs Y have admitted to the staff at the desk that they miss their grandchildren. He comes to see the GP to ask for some sleeping tablets.

Mr SY doesn't often attend the practice, he has been on Losartan for hypertension for five years and his recent review with the nurse (including cholesterol and renal function) was satisfactory.

Please describe the assessment of Mr SY in the GP consultation. Discuss the options available for the management of the patient. Besides medication, what strategies are available for the management of Mr SY's insomnia?

Mr SY does not attend surgery frequently, so his request for sleeping tablets would seem unusual and arouse my curiosity.

Type
Chapter
Information
Integrated Management of Depression in the Elderly , pp. 33 - 54
Publisher: Cambridge University Press
Print publication year: 2008

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