Management of Depression in Medical Patients: The Role of Clinical Evaluation

Fava, Giovanni A.; Guidi, Jenny

doi:10.1159/000533954

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Even though there are many questionnaires covering psychosocial aspects of medical illness [3,4,24], and patient-reported outcome measures appear to be particularly valuable [28], interviewing is the key instrument for collecting information on psychosocial aspects of medical disease. Individual perception of the stressfulness of an environment exceeding his/her resources (allostatic load), presence of depression, demoralization and anxiety, and health attitudes and behavior stand as particularly important in the clinical process [4,[29][30][31].…”

Section: Clinical Domainsmentioning

confidence: 99%

Clinical Interviewing: An Essential but Neglected Method of Medicine

Fava,

Sonino,

Aron

et al. 2024

Psychother Psychosom

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Clinical interviewing is the basic method to understand how a person feels and what are the presenting complaints, obtain medical history, evaluate personal attitudes and behavior related to health and disease, give the patient information about diagnosis, prognosis, and treatment, and establish a bond between patient and physician that is crucial for shared decision making and self-management. However, the value of this basic skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to inquire about problems and life setting may actually help to avoid further testing, procedures, and referrals. Moreover, the dialogue between patient and physician is an essential instrument to increase patient’s motivation to engage in healthy behavior. The aim of this paper was to provide an overview of clinical interviewing and its optimal use in relation to style, flow and hypothesis testing, clinical domains, modifications according to settings and goals, and teaching. This review points to the primacy of interviewing in the clinical process. The quality of interviewing determines the quality of data that are collected and, eventually, of assessment and treatment. Thus, interviewing deserves more attention in educational training and more space in clinical encounters than it is currently receiving.

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Section: Clinical Domainsmentioning

confidence: 99%

Clinical Interviewing: An Essential but Neglected Method of Medicine

Fava,

Sonino,

Aron

et al. 2024

Psychother Psychosom

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a patient with a symptomatology characterized by anxiety and depression of mild severity, we can shift into the domain of resistance what is simply the result of a treatment that has limited efficacy. Poor responsiveness to antidepressants is also a characteristic of symptomatic affective disorders that occur in a restricted number of medical diseases, where mood disturbances tend to subside with medical treatment (for instance, lowering of cortisol level in Cushing's syndrome) and relapse when such therapy is withheld [44].…”

Section: Assessing Treatment Responsementioning

confidence: 99%

“…These basic questions call for further evaluation that extends over several lines of inquiry. The first is concerned with the exploration of potential contribution of iatrogenic factors that may encompass medical [44] and psychotropic [41,45] drugs, as well as psychotherapy. A staging system for behavioral toxicity of medications has been developed [41,45] and may assist the physician in identifying specific iatrogenic manifestations.…”

Section: Assessing Treatment Responsementioning

confidence: 99%