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Kurt Kroenke, MD, Discussant

JAMA. 2002;287:1568-1576.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR BURNS: Mr S is a 75-year-old man who has had depressive symptoms for the past few years. He is married with 3 adult children and several grandchildren. He has managed Medicare insurance.

Mr S has no prior history of depression. He first began having difficulties with depression about 2 years ago following coronary artery bypass graft surgery, followed by an ablation procedure for persistent atrial fibrillation. Initially, the procedure was successful, but his rhythm later reverted to atrial fibrillation. His past medical history is otherwise noteworthy for hypertension, hyperlipidemia, benign prostatic hyperplasia, and seizure disorder (he had his last seizure in his 30s).

About 2 years ago, Dr W referred Mr S to a psychiatrist for depressive symptoms. Mr S started taking venlafaxine XR (75 mg/d) with improvement in his symptoms. In April 2001, his depression worsened. His dose of venlafaxine XR was . . . [Full Text of this Article]

MR S: HIS VIEW

DR W: HIS VIEW

AT THE CROSSROADS: QUESTIONS FOR DR KROENKE

Prevalence and Natural History

Differential Diagnosis

Evaluation

Initial Discussion With the Patient

Antidepressant Use and Treatment Monitoring

Referral to a Psychiatrist

Psychotherapy

Involving the Patient's Family

Recommendations for Mr S

QUESTIONS AND DISCUSSION

Author Affiliation: Dr Kroenke is Professor of Medicine, Senior Scientist, and Director of Fellowship Training, Department of Medicine, Indiana University School of Medicine and Regenstrief Institute for Health Care, Indianapolis, Ind.

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