Is major depression adequately diagnosed and treated by general practitioners? Results from an epidemiological study
| Autor: | Anna Fernández, Maria T. Peñarrubia, Antoni Serrano-Blanco, Elena Blanco, Rita Fernández, Jaume Autonell, Alejandra Pinto-Meza, Diego Palao, Pere Roura-Poch, Josep Maria Haro, Juan Ángel Bellón, Juan V. Luciano |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Mental Health Services medicine.medical_specialty Pediatrics Cross-sectional study Guidelines as Topic Neuropsychological Tests Severity of Illness Index Sampling Studies Diagnosis Differential Catchment Area Health Surveys and Questionnaires Severity of illness Epidemiology medicine Humans Medical prescription Major depressive episode Depression (differential diagnoses) Depressive Disorder Major Primary Health Care business.industry Gold standard Recognition Psychology Middle Aged Mental health Diagnostic and Statistical Manual of Mental Disorders Epidemiologic Studies Psychiatry and Mental health Treatment Outcome Spain Female Clinical Competence medicine.symptom Cognition Disorders business |
| Zdroj: | General Hospital Psychiatry. 32:201-209 |
| ISSN: | 0163-8343 |
| Popis: | Objectives The aim of this study was to (1) to explore the validity of the depression diagnosis made by the general practitioner (GP) and factors associated with it, (2) to estimate rates of treatment adequacy for depression and factors associated with it and (3) to study how rates of treatment adequacy vary when using different assessment methods and criteria. Methods Epidemiological survey carried out in 77 primary care centres representative of Catalonia. A total of 3815 patients were assessed. Results GPs identified 69 out of the 339 individuals who were diagnosed with a major depressive episode according to the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) (sensitivity 0.22; kappa value: 0.16). The presence of emotional problems as the patients' primary complaint was associated with an increased probability of recognition. Rates of adequacy differed according to criteria: in the cases detected with the SCID-I interview, adequacy was 39.35% when using only patient self-reported data and 54.91% when taking into account data from the clinical chart. Rates of adequacy were higher when assessing adequacy among those considered depressed by the GP. Conclusion GPs adequately treat most of those whom they consider to be depressed. However, they fail to recognise depressed patients when compared to a psychiatric gold standard. Rates of treatment adequacy varied widely depending on the method used to assess them. |
| Databáze: | OpenAIRE |
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