• Dominique Barbier.
• Psychiatre des hôpitaux, médecin légiste, Centre Hospitalier, 2, avenue de la Pinède 84143 Montfavet. barbier.d@wanadoo.fr
• Presse Med. 2004 Feb 14; 33 (3): 194200194-200.

AbstractDoubt, one of the fundamental symptoms of depression. Patients frequently believe they're incurable. They are persuaded that nothing can be done for them. Most of the time, when they are told, they do not accept that they are going through a crisis, a critical period in life. The ever repeated question is: "What's the use?" Which shows to what extent the person is depressed and disillusioned. For them there is nothing that can be of any use. A frequent problem. The Yearly prevalence of phases of major depression in the general population in France is of around 10% and throughout life of more than 10% in men and 20% in women. In France the estimation is that more than one out of 7 inhabitants is depressed. The role of the general practitioner. The physician must help those who surround the depressed patient, but it is often necessary that the practitioner refer to a consulting specialist who will specify what type of depression the patient is suffering from, eventually make an assessment (using specific scales) of the intensity of the episode, and indicate which type of antidepressor is best adapted, the side effects that should be monitored, the associations to be avoided, and any control biological assays to be foreseen. The role of the specialist. In parallel, the specialist will schedule a psychotherapy, either maintenance or more structured (in such a way that the patients, if they wish, can work on the mechanisms that provoked the depression and hence protect themselves against any eventual relapse). The interest of co-therapies. It can be interesting that the general practitioners and specialists collaborate in the necessity for hospitalisation or not (with patient's consent or not), monitoring of a suicide risk, or the need to change treatment. The sharing of the tasks is always very positive for the patients. The patients, as those who surround them, are reassured by the fact that the family doctor and a specialist are collaborating in order to optimise treatment as rapidly as possible. The organisation of such co-therapies requires that the general practitioner also have good knowledge of the various types of psychotherapy available for the patient.

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