Vicente Gasull, primary care doctor in Department 9 of Valencia and coordinator of the Semergen Mental Health Group.
With the aim of helping to make depression visible, Lundbeck has taken the 44th National Congress of the Spanish Society of Primary Care Physicians (Semergen) Elena’s Journey”. A virtual experience that was created in 2021 from the more than 500 testimonials of people who have gone through this disease and who show their stories, emotions and thoughts in the first person. These shared experiences were the source of inspiration for the illustrator Ana Santos to create the 12 illustrations that make up this exhibition.
To learn first-hand about the link between Primary and depression, Medical Writing interview to Vicente Gasull, coordinator of the Semergen Mental Health Group, who clarifies that the 50 percent of patients with depression are detected by Primary Care doctors. A figure that could increase, according to many health professionals in this area, if there were specific training in mental health and a longer average time for each consultation, which is currently only 7 minutes. “This makes it difficult to establish a good doctor-patient relationship, which is key for early diagnosis and adherence to treatment in people suffering from a depressive disorder,” Gasull details.
Why have they brought the Elena’s Journey to the 44th National Congress of the Spanish Society of Primary Care Physicians (Semergen)?
Because Primary Care doctors are the gateway to the health system and, generally, patients cannot go to a psychiatrist if they do not go through the Family doctor first. In addition, on many occasions the patient does not directly state the symptoms of depression and it is very important that the primary care doctor knows how a depressive disorder can manifest and detect those clues that can lead the doctor to generate an early diagnosis. It is very common for the patient to consider it a sign of weakness and not even tell the family.
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Vicente Gasull, primary care doctor in Department 9 of Valencia and coordinator of the Semergen Mental Health Group. |
Can Elena’s Journey help by raising awareness among family doctors of the importance of depression and the rise that is being experienced in young people?
Yes, because in the end Elena’s journey is a summary of the opinion of 500 patients who have written what they have felt when they have depression and in its different stages. It is important because if we think that depression is a chronic disease, it is not only at the beginning but throughout its evolution. There we must know how the patient is progressing, what he is thinking, how he may have a risk of abandoning medication, what adverse effects he may have… All this is captured in a graphic way. So it helps to understand the disorder and the Primary Care doctor must know this.
Can you help him anticipate problems?
Effectively, or at least to carry out a follow-up plan in accordance with these possible changes.
What would you say to a family doctor so that he stops to look at Elena’s Journey?
That there you will find a very easy, understandable and very quick explanation of what the patient feels and why we must get involved and have a proactive attitude for the treatment of these patients in a problem that is increasingly frequent in our society.
Vicente Gasull. |
What is the role of the family doctor in the detection of depression?
The family doctor plays a crucial role. In depression, early detection is key, it has been shown that the longer you take to make the diagnosis, the chances of achieving remission of the condition are less and less. We know that many depressions are manifested by somatic symptoms, which have nothing to do with mood or affect, but with difficulty concentrating or falling asleep. Given all this, the family doctor must have a proactive attitude and, through their symptoms, arrive at a diagnosis as early as possible so that the results are better.
In addition, depression is an illness that requires chronic treatment. For example, a first episode requires between 9 and 11 months of treatment. It is very easy for the patient to begin to feel better and begin to receive messages contrary to the treatment and decide to leave it. The doctor should consider regular follow-up to assess adverse effects that may appear, if he is responding to treatment and assess his adherence to it.
So, is the family doctor the one who is from the beginning to the end?
Undoubtedly. Even when the end is reached, many patients feel that they are not the same as they were before. Residual symptoms remain and if that patient stops the medication, the chances of relapse are greater. The doctor must be vigilant so that treatment is not abandoned and if these symptoms remain, modify it so that total remission is achieved.
Iván Fernández, editor of Specialties, and Vicente Gasull, during the interview with Medical Writing. |
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