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International Primary Care Association

Clinical Focus Volume 3 N2

Volume 3 Issue 2 - 2008


Depression is a very common disorder, with a 5–10% prevalence in primary care settings.1 It has been estimated (by the World Health Organisation) that by the year 2020, depression will be the second most common cause of disability in the developed world, and the number one cause in the developing world.2 Women are approximately twice as likely as men to experience a depressive episode within a lifetime and the lifetime risk is 15% overall.3 Not only do depressive disorders have significant potential morbidity and mortality – the death rate may be as high as 15% - but they also contribute to increased mortality and morbidity when associated with other physical disorders.

With this is in mind, it is of some concern that up to half of the patients with a major depressive illness are not diagnosed and those who are diagnosed are often not adequately treated.4 Most depressive states are at the mild to moderate end of the spectrum and are managed mainly in primary care. In fact, 80% of people identified as having depression are managed entirely in a primary care setting.


Chronic Fatigue Syndrome (CFS) is a debilitating disease with predominant symptoms being severe disabling fatigue (unrelieved by rest); unrefreshing sleep; widespread pains and neurological problems. Despite its official recognition by the Chief Medical Officer over eight years ago, the literature reflects that the diagnosis and management of CFS still today cause controversy and apprehension within the medical profession, especially within primary care. This summary aims to highlight key characteristics, maintaining factors, nature and impact, possible disease mechanisms and management techniques to aid medical professionals to diagnose and treat patients more effectively.


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