Podcast: Depression

Dr. Laurence J. Kirmayer will describe the key points of the Depression review of the Canadian Collaboration for Immigrant and Refugee Health Evidence-based clinical guidelines

Key points

New immigrants to Canada show lower rates of depression than the general population, but these rates generally rise to match the general population rate over time. Prevalence of depression in refugees is comparable to that in the general population.

Existing guidelines for depression for the general population are likely to apply to immigrants and refugees. These guidelines suggest that all patients should be screened for depression when integrated systems are in place to provide follow-up treatment.

Primary care for immigrants should provide descriptive materials regarding depressive disorder in relevant languages, translated screening questions and trained interpreters to facilitate the diagnostic interview, and systematic inquiries about losses, stressors and symptoms.

Mild depressive symptoms should be treated with education in self-management techniques with follow-up to assess resolution. Moderate to severe cases should be treated with a stepped-care model beginning with psychoeducation and antidepressant medication, close follow-up, and culturally appropriate counselling.

CMAJ evidence review

Evidence Based Migrant Health Network