General practitioners' conceptions about treatment of depression and factors that may influence their practice in this area. A postal survey

被引：11
作者：
Andersson S.J. [1 ,2 ,3 ]
Troein M. [1 ]
Lindberg G. [2 ]
机构：
[1] Lund University, Department of Clinical Sciences Malmö, Family Medicine
[2] NEPI Foundation, Malmö
[3] Research Department of Primary Care, County Council of Värmland, Karlstad
来源：
BMC Family Practice | / 6卷 / 1期
关键词：
Depressive Disorder; Pharmaceutical Company; Depressed Patient; Social Phobia; Panic Disorder;
D O I：
10.1186/1471-2296-6-21
中图分类号：
学科分类号：
摘要：
Background: The way GPs work does not appear to be adapted to the needs of depressive patients. Therefore we wanted to examine Swedish GPs' conceptions of depressive disorders and their treatment and GPs' ideas of factors that may influence their manner of work with depressive patients. Methods: A postal questionnaire to a stratified sample of 617 Swedish GPs. Results: Most respondents assumed antidepressive drugs effective and did not assume that psychotherapy can replace drugs in depression treatment though many of them looked at psychotherapy as an essential complement. Nearly all respondents thought that clinical experiences had great importance in decision situations, but patients' own preferences and official clinical guidelines were also regarded as essential. As influences on their work, almost all surveyed GPs regarded experiences from general practice very important, and a majority also emphasised experiences from private life. Courses arranged by pharmaceutical companies were seen as essential sources of knowledge. A majority thought that psychiatrists did not provide sufficient help, while most respondents perceived they were well backed up by colleagues. Conclusion: GPs tend to emphasize experiences, both from clinical work and private life, and overlook influences of collegial dealings and ongoing CME as well as the effects of the pharmaceutical companies' marketing activities. Many GPs appear to need more evidence based knowledge about depressive disorders. Interventions to improve depression management have to be supporting and interactive, and should be combined with organisational reforms to improve cooperation with psychiatrists. © 2005 Andersson et al; licensee BioMed Central Ltd.
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[1]  
The Changing Rate of Major Depression. Cross-National Comparisons, JAMA, 268, pp. 3098-3105, (1992)
[2]  
Kessler R.C., Berglund P., Demler O., Jin R., Koratz D., Merikangas K.R., Rush A.J., Walters E.E., Wang P.S., The epidemiology of Major Depressive disorder. Results from the National Comorbidity Survey Replication (NCS-R), JAMA, 289, pp. 3095-3105, (2003)
[3]  
Kirmayer L.J., Robbins J.M., Dworkind M., Yaffe M.J., Somatization and the recognition of depression and anxiety in primary care, Am J Psychiatry, 150, pp. 734-741, (1993)
[4]  
Lecrubier Y., Prescribing Patterns for Depression and Anxiety Worldwide, J Clin Psychiatry, 62, pp. 31-36, (2001)
[5]  
Bingefors K., Isacson D.G., Concomitant prescribing of tranquilizers and hypnotics among patients receiving antidepressant prescriptions, Annals of Pharmacotherapy, 32, pp. 531-535, (1998)
[6]  
Bingefors K., Prescription drug and health care use among Swedish patients treated with antidepressants, Antidepressant-treated Patients. Population-based Longitudinal Studies, pp. 25-41, (1996)
[7]  
Bodlund O., Ångest och depression dolt problem i primärvården, Läkartidningen, 94, pp. 4612-4618, (1997)
[8]  
Bodlund O., Flertalet deprimerade patienter kan behandlas i primärvården, Läkartidningen, 97, pp. 1244-1249, (2000)
[9]  
Orrell M., Collins E., Shergill S., Katona C., Management of depression in the elderly by general practitioners: Use of antidepressants, Family Practice, 12, pp. 5-11, (1995)
[10]  
Rosholm J.-U., Gram L., Damsbo N., Hallas J., Antidepressant treatment in general practice - An interview study, Scand J Prim Health Care, 13, pp. 281-286, (1995)
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