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Anxiety and depressive disorders are usually primary disorders, occuring in the absence of underlying pathology. Despite this, consideration should be given to the possible psychiatric, medical and drug causes that may affect treatment.

	Other psychiatric disorders: Depressive disorders and anxiety disorders often coexist and are often secondary to other psychiatric disorders. Also consider past manic episodes, pointing to a diagnosis of bipolar disorder.
	Medical conditions: For depression, neurological and endocrine disorders are commonest, but also consider underlying infections and malignancy. For anxiety, endocrine and cardiac disorders are important, as are seizure disorders.
	Drugs: Drugs commonly associated with depression are antihypertensive agents, corticosteroids, oral contraceptives and antineoplastic agents. Alcohol and amphetamines can cause depression either during intoxication or withdrawal. Drugs commonly associated with anxiety are sympathomimetics such as amphetamines, cocaine and caffeine, antihypertensives, especially captopril, and non-steroidal anti-inflammatory drugs. Drugs that increase serotonin release, such as LSD and MDMA ("ecstasy"), can cause acute and chronic anxiety.

On to Managing depression in a community setting . . .