Depression after myocardial infarction (MI) is extremely common, affecting almost half of all patients. The combination of MI and depression reduces the chance of recovery and makes it much more likely that patients will have another cardiac event. Depressed patients are also less likely to get back to work and they use health services more than those who are not depressed. We carried out a survey to investigate the perceptions, attitudes and skills of primary care practitioners in recognising and treating depression in patients following an MI to explore how this important co-morbidity is managed in practice. Readers of the British Journal of Primary Care Nursing (BJPCN) were invited to participate in an online survey, together with readers of the Primary Care Cardiovascular Journal. The survey results show that although primary healthcare practitioners realise that depression after MI is a significant problem, many underestimate quite how common it is and have received little or no training in recognising or managing depression.
Cognitive behavioural therapy (CBT) is a combination of two types of therapy: cognitive (how we think about things) and behavioural (what we do). NICE guidelines recommend CBT as a frontline therapy for depression, obsessive compulsive disorder, post-traumatic stress disorder and anxiety. The National Institute of Mental Health suggests that a combination of CBT and medication may be the best treatment for many patients with panic disorder. As CBT is moving higher up the therapy agenda, this article takes you through what it is and what it involves in practice.
Dementia is a term used to describe a syndrome that can be caused by several illnesses, but the result is a decline in a person's abilities to function socially, mentally and in relation to the everyday activities of living. The condition is having an increasing impact on individuals, families and care services as the UK population ages. However, practice nurses can help make the experience of living with dementia more positive for the patient and their families or carers.
Although substantial concerns have been raised previously about the neuropsychiatric safety of varenicline and bupropion, a new study shows that these popular aids to quitting smoking do not put patients at increased risk.
Compared with the rest of the population, people with long-term conditions—especially cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD) and musculoskeletal disorders—have two to three times the risk of experiencing a mental health problem. In this article we will consider how these issues affect long-term conditions, how we can assess their impact and how we can improve the psychological wellbeing of these patients.
Deaths from cardiovascular disease have fallen over the last 20 years but people with schizophrenia and bipolar illness have not shared in these benefits. At the end of last year the first National Audit of Schizophrenia highlighted important deficiencies in management. A systematic care pathway, and straightforward screening, treatment and follow-up in primary care could reduce the continuing health inequalities experienced by people with severe mental illness.
The NHS Health Check is changing again. Since the beginning of April 2013, practice nurses have been expected to raise the issue of dementia when seeing patients aged 65-74. But why (I can hear you ask)? Surely we have enough to do! This article explains why dementia matters, and sets out your role in the NHS Health Check.
The revised new GMS contract recommends that we screen patients with coronary heart disease (CHD) and diabetes for depression. This is evidence-based, as we know that people with long-term conditions are at high risk of anxiety and depression; but who is going to do it, how is it done and when do we find the time? It would seem obvious to include some sort of screening process in the annual CHD or diabetes review – but is this feasible? In this article we review practical ways of screening for depression in patients with CHD and diabetes.