Background: Obesity management in general practice sometimes involves referral of patients for bariatric surgery. Integral to the success of long-term weight loss maintenance is supporting the patient's psychological, nutritional and exercise needs.
Objective: This article is written to equip general practitioners (GPs) to manage the comprehensive needs, before and after bariatric surgery, of patients who are obese.
Discussion: The number of patients undergoing bariatric surgery in Australia has increased significantly in the past few years. Pre-operative and postoperative management of this intervention presents a challenge for GPs. In this article we provide guidance around psychological, nutritional and exercise interventions, to equip GPs in managing patients who are obese. Access to allied health providers is not always available for patients, so this article is co-written with allied health colleagues who share their expertise as a resource for GPs.
Background: Major depressive disorder (MDD) in children (5-12 years of age) is a confronting and serious psychiatric illness. MDD has significant ramifications for the psychosocial development of the child, yet it remains under-recognised and undertreated. General practice is where these children and their parents will first present.
Objective: The aim of this article is to provide general practitioners (GPs) with a framework for considering MDD in a child and recommendations for treatment.
Discussion: Children with MDD have the same core features as adolescents and adults, taking into account the child's capacities for cognition and language, and developmental stage. Earlier onset of illness is associated with poorer outcomes and greater psychiatric morbidity persisting into adulthood. MDD is more common than anticipated, and should be considered for any child presenting with depressive symptoms and/or impaired psychosocial functioning. Despite limited evidence, numerous interventions exist that will, ideally, significantly affect the child's developmental trajectory. GPs are in an important position to initiate these interventions.
Background: Growth is one of the fundamental processes of adolescent development. Careful history and examination, and relevant tar-geted investigations, can streamline the referral process, highlighting the important role of primary healthcare clinicians.
Objective: This article will provide a guide for clinicians to categorise growth patterns in adolescents, and recognise patients who may have a growth disorder. It will assist clinicians in considering appropriate investigations, and provide guidance for when to refer the adolescent to appropriate paediatric specialists.
Discussion: Causes of tall and short stature can often be distinguished on history, physical examination, and accurate pubertal staging. The height of the adolescent should always be considered in the context of their genetic potential. Physiological variants re-main the most common reason for short stature, but awareness of the features of pathological causes is critical. One of the most common presentations is maturational delay in males, and an approach to this issue is discussed.
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