This course provides the non-psychiatric physician with an up to date approach to the assessment and treatment of major depression in the primary care office setting. The program defines the key features and sub-classificant of depressive disorders and relates the subclassification to concrete treatment planning and medication prescribing issues. A longitudinal perspective on longterm management issues and relapse prevention is provided. Critical issues in the assessment of suicide risk are described. Case vignettes illustrate key principles of treatment management within a practical clinical context.

The impact of specific medical conditions on assessment and management of depression is highlighted, as is the interaction of antidepressant medications with medications utilized in general medical practice. Concrete strategies for the selection of antidepressants and the sequencing of antidepressant treatments in patients who fail to respond to initial medication trials is discussed in detail. Important issues guiding the choice of a specific antidepressant are discussed in detail. Guidelines as to how to approach referral for psychotherapy are described, as are recommendations regarding referral for consultation by a psychiatrist. All key teaching points are illustrated by case based teaching of real world clinical challenges encountered in everyday practice.

NUMBER OF CREDIT HOURS: The Harvard Medical School designates this enduring material for a maximum of 4 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 4 hours to complete.

COST: $80.00 for the average learner. Participants living in emerging nations receive a 50% discount or can register for free. See our International Pricing Page for details.

OVERALL LEARNING OBJECTIVES:

1. Appreciate the criteria for diagnosing mood disorders including major depression and its subcategories
2. Understand the significance of subcategories of major depression and their implications for treatment planning
3. Identify significant medical and psychiatric comorbid disorders that impact on the assessment and treatment of mood disorders
4. Assess key issues in the patient’s presentation and longitudinal history, including the use of interview instruments
5. Evaluate patient safety and suicide risk
6. Formulate an appropriate initial psychopharmacological and psychotherapeutic treatment plan
7. Develop criteria for referral for psychiatric consultation

CLINICAL LEARNING OBJECTIVES:

1. Enhance knowledge of the sub-classification of depressive disorders
2. Enhance understanding of the psychopharmacological treatment of depressive disorders
3. Enhance skills in assessing risk factors for suicide and adverse events
4. Enhance skills in treatment planning, integrating both psychotherapy and psychopharmacology recommendations
5. Develop understanding of the sequencing of psychopharmacologic treatments for depression in patients that fail an initial antidepressant medication trial
6. Increase understanding of timely use of psychiatric consultation

METHOD OF PARTICIPATION:

Registrants participate in the learning process by answering interactive multiple choice questions that are dispersed throughout the case presentation. You must answer a question correctly in order to continue through the course. If you answer a question incorrectly, you will be prompted to try again.

In order to earn credit, physicians must complete the entire educational activity before the termination date (see above). Non-physicians may register for the course but are not eligible for AMA PRA Category 1 Credits™. Instead, non-physicians will earn a certificate of participation after successfully completing the course before its termination date.

COMBINATION OF MEDIA USED:

This internet enduring material is a case-based, interactive presentation comprised mainly of text, interactive questions, and images. A variety of media, including video clips, audio clips, and Flash animation, may be presented. Links to any necessary plugins are provided when necessary, but no plugins are required for general use of the CME website, and you may skip the multimedia presentation(s) within the course if you choose.

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RUSSELL VASILE, MD Course Director

Russell G. Vasile MD is an Associate Professor of Psychiatry, Harvard Medical School, and Director of the Affective Disorders Consultation Program at the Beth Israel Deaconess Medical Center in Boston. He is a graduate of Princeton University, Class of 1970, and Harvard Medical School, Class of 1974. He completed his psychiatric residency training at the Harvard Medical School –Massachusetts Mental Health Center program in 1978. He is a Distinguished Fellow of the American Psychiatric Association. Dr. Vasile has published in diverse areas related to the assessment and treatment of depression and anxiety disorders. These publications have included topics such as the psychopharmacologic management of depression and anxiety disorders, biopsychosocial approaches to affective disorders consultation, and the use of brain imaging in the assessment of neuropsychiatric disorders. Dr. Vasile is a graduate of the Boston Psychoanalytic Society and Institute, and is certified in Forensic Psychiatry. He is a past recipient of the Elvin V. Semrad Award for Excellence in Teaching at the Massachusetts Mental Health Center. He has presented an annual program on advances in the treatment of affective disorders for the Harvard Medical School Continuing Medical Education Program over the past 15 years. DISCLOSURE: Reported no current relevant financial relationships with commercial entities. (Through 2009: Company: Pfizer, Forest, and Wyeth. Speakers Bureau. Content area: Mood Disorders.)

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MARK D. ARONSON, MD Reviewer

Dr. Aronson is a Professor of Medicine at the Beth Israel Deaconess Medical Center in Boston, MA. DISCLOSURE: UpToDate Inc.: Co-editor in adult medicine and primary care

JOHN MOONEY, MD Reviewer

John J. Mooney MD is an Assistant Professor of Psychiatry at HMS and a member of the Affective Disorders Consult Servicec at BIDMC. He is a graduate of Harvard College, Yale Medical School, and the psychiatric residency program at Mass. Mental Health Center. He has 20 publications on the pathophysiology of depressive disorders, and has a particular interest in cell signaling systems in depressive disorders. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

CHRISTOPHER PALMER, MD Reviewer

Dr. Christopher Palmer is the Medical Director for the Department of Postgraduate and Continuing Education at McLean Hospital and a research physician in the Behavioral Psychopharmacology Research Laboratory and the Sleep Research Program, both at McLean Hospital. He is an Instructor in Psychiatry at Harvard Medical School. He conducts a private practice of psychiatry, specializing in treatment-resistant cases and also has significant teaching roles in a variety of settings, including continuing education conferences and medical student teaching at Harvard Medical School. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

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SANJIV CHOPRA, MD Planner

Dr. Sanjiv Chopra is Professor of Medicine and Faculty Dean for Continuing Medical Education at Harvard Medical School and Senior Consultant in Hepatology at the Beth Israel Deaconess Medical Center, Boston. In his role as Faculty Dean for Continuing Education, Dr. Chopra provides oversight and leadership of the Department and oversees the academic development of our programs. Dr. Chopra is an experienced clinician, researcher, and educator. In his research roles, he has served both as a principal investigator as well as co-investigator. He has more than 120 publications and five books to his credit, addressing topics in disease states, patient care, and leadership. Dr. Chopra’s teaching experience is extensive, and he has won numerous teaching awards for his work with medical students, residents and physicians. Currently, he directs and speaks at 10 multiday CME courses, nine of which are through HMS. For his full bio, please click here. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

ANDI LONG, EDM Planner

Andi Long directs the Department of Continuing Education’s Distance Learning group, which offers a variety of online continuing medical education programs to health care professionals around the world. Andi develops strategies for new pilot programs and systematically rolls out new distance learning initiatives and has a leadership role in IT planning and other online processes for HMS DCE. She oversees the day-to-day operations of each distance learning activity and ensures ACCME compliance across all enduring programs. She has had the privilege of working with hundreds of Harvard Medical School Faculty members to develop high-quality, engaging online programs that physicians in more than 170 countries have taken part in. Andi earned her Ed.M. in Technology, Innovation, and Education from Harvard Graduate School of Education and graduated from Bridgewater State College, summa cum laude, with a degree in English. Her professional interests focus on teaching and learning with new technologies and online course development. DISCLOSURE: Reported no relevant financial relationships with commercial entities.

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NUMBER OF CREDITS: 4 

The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this enduring material for a maximum of 4 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This course should take approximately 4 hours to complete.

Within 2 weeks of completing the course, you will receive your certificate via email.

Click the image to view a sample of the certificate

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