Depression in a family practice in Japan: doctor shopping and patient complaints

Yamada, K; Maeno, Tetsuhiro; Ono, Maiko; Sato, Takeshi; Otsubo, Tempei; Isse, Kunihiro

doi:10.1185/135525705x40355

Cited by 3 publications

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“…Measurements.— Before consulting the doctor, the subjects were asked to complete a self‐report questionnaire 17 in the waiting room. The questionnaire was developed based on previous studies 8,12,14 involving primary care patients, and included questions pertaining to (1) patient demographics; (2) duration of headaches (less than 1 month/1–6 months/6 months or more); (3) severity of headaches (using a 5‐point Likert scale ranging from 1 (no pain) to 5 (most insufferable pain); (4) changes in headache severity; (5) other symptoms (fatigue, chest pain, abdominal pain, back pain, appetite loss, insomnia, numbness, dizziness, others); and (6) whether or not patients were distressed high utilizers.…”

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confidence: 99%

Indicators of a Major Depressive Episode in Primary Care Patients With a Chief Complaint of Headache

Maeno¹,

Inoue²,

Yamada

et al. 2007

Headache

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Objective.—To identify the indicators of major depressive episode (MDE) in primary care patients with a chief complaint of headache. Background.—MDE is very frequent among headache patients in primary care. However, primary care physicians often fail to recognize the coexistence of MDE. Methods.—A total of 177 consecutive new adult patients who visited 19 primary care clinics from January 2002 to December 2002 with a chief complaint of headache were enrolled in the study. All subjects completed a self‐report questionnaire that included questions regarding the duration and severity of their headaches, changes in headache severity, and other symptoms. The questionnaire also identified distressed high utilizers (patients who consulted different doctors for the same episode of an illness, without being referred). MDE was diagnosed using a module of the mini international neuropsychiatric interview (MINI). To identify potential indicators of depression, both univariate analysis and multiple logistic regression analysis were performed. Results.—Forty‐five of 177 patients (25.4%) fulfilled the diagnostic criteria for MDE. Univariate analysis revealed that severe headache, longer duration of headaches, multiple somatic symptoms, and being a distressed high utilizer were associated with MDE. Multiple logistic regression analysis revealed that patients with headaches lasting 6 months or longer and those with multiple somatic symptoms were more likely to be suffering from MDE (adjusted odds ratios: 3.1, 95% CI: 1.7–10.6; and 3.9, 95% CI: 1.2‐8.1, respectively). Conclusions.—MDE is highly prevalent in headache patients visiting a primary care setting. Multiple somatic symptoms and longer duration (≥6 months) of headaches are particularly useful indicators of MDE.

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confidence: 99%

Indicators of a Major Depressive Episode in Primary Care Patients With a Chief Complaint of Headache

Maeno¹,

Inoue²,

Yamada

et al. 2007

Headache

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“…Among the 112 patients screened in this survey, the rates of major depression and alcoholism were 4.5% and 7.1%, respectively. Both major depression and alcoholism have a reported prevalence of 3.7% among new adult patients in Japanese family practice, when the J-MINI is used [ 16 ]. Using the Diagnostic Interview Schedule (DIS), the prevalence among first-visit adult patients seen in general medicine outpatient clinics in Japan is reported to be 4.7% for major depression and 9.4% for alcoholism [ 17 ].…”

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confidence: 99%

Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

Yamada

Maeno

Waza³

et al. 2008

Asia Pacific Family Medicine

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AimThe aim of this survey was to assess the accuracy of a family physician's diagnosis of depression and alcoholism.MethodsConsecutive new adult patients attending a family practice in Japan between April 2004 and August 2006 were enrolled. Excluded were those with dementia or visual disturbance, and emergency cases. Participants completed a questionnaire regarding their complaints and socio-demographics. A research nurse conducted the Japanese version of the Mini-International Neuropsychiatric Interview (J-MINI) in the interview room. The doctor independently performed usual practice and recorded his own clinical diagnoses. A researcher listed the clinical diagnoses and complaints, including J-MINI or clinically-diagnosed alcoholism and depression, using the International Classifications for Primary Care, Second Edition (ICPC-2) and calculated kappa statistics between the J-MINI and clinical diagnoses.ResultsOf the 120 adult first-visit patients attending the clinics, 112 patients consented to participate in the survey and were enrolled. Fifty-one subjects were male and 61 female, and the average age was 40.7 ± 13.2 years. Eight alcohol-related disorders and five major depressions were diagnosed using the J-MINI, whereas no cases of alcoholism and eight depressions were diagnosed by the physician. Clinically overlooked patients tended to have acute illnesses like a common cold. Concordance between the clinical and research diagnosis was achieved only for three episodes of Major depression, resulting in a kappa statistic of 0.43.ConclusionAlthough almost half of the major depressions were identified, all alcoholism was missed. A mental health screening instrument might be beneficial in family practice, especially to detect alcoholism.

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Beyond the medical file: a scoping review on patients’ perspectives on guideline-oriented depression treatment in primary care

Biersack,

Sattel,

Schönweger

et al. 2023

Preprint

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ObjectivesDepressive disorders are common in the primary care setting. Primary care practitioners must deal with different disorders and keep up with evidence-based treatment. Clinical practice guidelines (CPG) offer accessible information about up-to-date care but are poorly implemented. Research on the implementation of CPGs has focused on the practitioners’ perspective but has neglected the patients’ perspective largely.This scoping review aimed to identify terms related to the concept of ‘patients’ perspectives on depression treatment in primary care building a comprehensive framework and to identify researched barriers and facilitators to partaking in care.MethodsWe conducted a scoping review on Medline and Psycinfo. Eligible publications contained information from the patients’ point of view on depression treatment in primary care in OECD member states. We used the PCC-framework to obtain inclusion criteria. Publications until August 2nd 2023 were considered.ResultsWe included 232 publications. Current literature focuses on behavioral and easily collected measures like satisfaction and on patient-sided barriers and facilitators to adherence. Other treatment-related behaviors are less researched. Patients often report exclusively or mainly physical symptoms in their visits which can impede diagnosis.ConclusionThis review provides a comprehensive framework for the concept. Research on the patients’ perspective on depression treatment in primary care is still inconclusive.RegistrationThis review is registered via OSF (https://osf.io/p9rnc).

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Depression in a family practice in Japan: doctor shopping and patient complaints

Cited by 3 publications

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Indicators of a Major Depressive Episode in Primary Care Patients With a Chief Complaint of Headache

Indicators of a Major Depressive Episode in Primary Care Patients With a Chief Complaint of Headache

Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

Beyond the medical file: a scoping review on patients’ perspectives on guideline-oriented depression treatment in primary care

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