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Órgano de Difusión de la Asociación Académica Panamericana de Medicina Familiar A.C.

2008, Number 2

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Arch Med Fam 2008; 10 (2)

A Patient with Chronic Severe Depression Treated by Her Family Physician. A Case Report

Ramírez–Villaseñor I

Language: Spanish
References: 15
Page: 27-33
PDF size: 105.94 Kb.


ABSTRACT

We report the case of a 51-year-old woman; she had been suffering from severe depression for the last 7 years. During that time, disability certificates for work were given to her on average for 50 days annually. In addition to these, treatment with three psychiatrists had proved useless. At the time psychotherapy was initiated with her family physician, the patient was also being treated by a fourth psychiatrist, who prescribed mirtazapine (Remeron) and ethyl loflazepate, a benzodiazepine. The latter, Victam, had been administered during the last 2 years. Family Medicine intervention focused on three areas: 1. Reincorporating the patient her into her work routine as soon as possible; 2. avoiding the use of Central nervous system CNS)-depressing drugs, and 3. teaching the patient a dynamic way of thinking to facilitate understanding the manner in which ideas can be changed by will. The patient was treated from Aprilto September 2003, and treatment goals were achieved. One year later, in September 2004, the patient continued working without disability certification. She was given benzodiazepines for 2 weeks only during that time period, but the plan for long-term antidepressive drug administration remains in place. Techniques used in treatment included the patient’s Background, the patient’s Affect, the patient’s most Troubling problem, the patient’s Handling of the problem, and a response that conveys Empathy (the brief psychotherapeutic BATHE technique), the genogram, and cognitive techniques.


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