John W. Williams, Jr., MD, MHSc; Gary Maslow, MD, MPH
This article was published at www.annals.org on 9 February 2016.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0104.
Requests for Single Reprints: John W. Williams Jr., MD, MHSc, Division of General Internal Medicine, Duke University School of Medicine, 411 West Chapel Hill Street, Suite 500, Durham, NC 27701; e-mail, email@example.com.
Current Author Addresses: Dr. Williams: Durham Veterans Affairs Medical Center, 411 West Chapel Hill Street, Suite 500, Durham, NC 27701.
Dr. Maslow: Duke Health Center at Roxboro Street, 4020 North Roxboro Street, Durham, NC 27710.
Williams J., Maslow G.; Seize the Day to Implement Depression Guidelines. Ann Intern Med. 2016;164:372-373. doi: 10.7326/M16-0104
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Published: Ann Intern Med. 2016;164(5):372-373.
Published at www.annals.org on 9 February 2016
Improving the care for persons with depression is a public health priority. Depression is common, causes enormous suffering, and increases the risk for suicide. The negative effects of depression extend beyond the individual patient to family members and employers. Depressive disorders often begin during adolescence and may be chronic or recurring. In adolescents, suicide is the second leading cause of death (1). Depression is treatable, with a range of options that include antidepressant medications, evidence-based psychotherapies, and complementary therapies. Most persons with depression are initially diagnosed and treated in general medical settings. Improving the recognition and treatment of depression within primary care would have enormous benefit. The U.S. Preventive Services Task Force (USPSTF) and the American College of Physicians (ACP) are trusted sources for clinical practice guidelines and with good reason. Both groups use systematic and transparent methods for guideline development. In this issue, 2 clinical practice guidelines, together with supporting systematic reviews, address depression screening in adolescents and treatment in adults (2–5).
Frederick W. Hund, MD, FACP
Affiliated Community Medical Centers
February 16, 2016
Depression and Exercise
To the Editor: I read with interest your recent opinion, "Seize The Day on Depression Guidelines". (1) However, I was disturbed by your characterization of exercise as one of a range of "...complementary and alternative medicine treatments" for depression, as opposed to the 'standard' treatments of second generation antidepressants and/or psychotherapy. Hippocrates included exercise as part of his "regimen": "If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health." Galen, Mendez and many others in past centuries also advised it. More recently, Paul Dudley White, as well as a past president of AMA and multiple reports of the Surgeon General have advocated exercise. (2). The benefits of exercise are legion and well established. It helps prevent diabetes and dementia. It treats dyslipidemia, hypertension, osteoarthritis and many other conditions, including, as you note, depression.Have we so lost our way as a profession that this ancient advice, confirmed and endorsed by our modern science is now considered a "complementary and alternative medicine treatment"? 1. Ann Intern Med. Published online 9 February 2016 doi:10.7326/M16-01042. Berryman, J.W. Exercise is medicine: a historical perspective. Curr. Sports Med. Rep., Vol. 9, No. 4, pp. 00Y00, 2010
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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