Following Depression in Primary Care: Do Family Practice Physicians Ask About Depression at Different Rates Than Internal Medicine Physicians?

Ga, Nichols; Jb, Brown

doi:10.1001/archfami.9.5.478

Cited by 13 publications

(4 citation statements)

References 16 publications

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“…5,8,12,13,18,21,37,[41][42][43] Variations by specialty are also consistent with the literature on practicing physicians' counseling behaviors. 3,24,37,[44][45][46][47] Within each specialty, the deficits in residents are similar to the deficits in practicing physicians, indicating a need to improve residency training and faculty development.…”

Section: Discussionmentioning

confidence: 99%

Perceived preparedness to provide preventive counseling

et al. 2005

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OBJECTIVE:To assess the perceived preparedness of residents in adult primary care specialties to counsel patients about preventive care and psychosocial issues. DESIGN:Cross-sectional national mail survey of residents (63% response rate).PARTICIPANTS: Nine hundred twenty-eight final-year primary care residents in Internal Medicine (IM), family practice (FP), and Obstetrics/Gynecology (OB/GYN) at 162 U.S. academic health centers. MEASUREMENTS:Residents self-rated preparedness to counsel patients about smoking, diet and exercise, substance abuse, domestic violence, and depression. RESULTS:Residents felt better prepared to counsel about smoking (62%) and diet and exercise (53%) than about depression (37%), substance abuse (36%), or domestic violence (21%). In most areas, females felt better prepared than males. Rates of counseling preparedness varied significantly by specialty after adjustment for gender, race, medical school location, and percent of training spent in ambulatory settings. FP residents felt better prepared than OB/GYN residents to counsel about smoking, diet and exercise, and depression, while OB/GYN residents felt better prepared to address domestic violence than IM or FP residents. IM residents' perceptions of preparedness were between the other 2 specialties. Proportion of training spent in ambulatory settings was not associated with residents' perceived preparedness.CONCLUSIONS: Physicians completing residencies in adult primary care did not feel very well prepared to counsel patients about preventive and psychosocial issues. Significant differences exist among specialties, even after adjusting for differences in time spent in ambulatory settings. Increasing residency time in ambulatory settings may not alone be sufficient to ensure that residents emerge with adequate counseling skills.

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Section: Discussionmentioning

confidence: 99%

Perceived preparedness to provide preventive counseling

et al. 2005

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“…Nonetheless, self-reported depressive symptoms, which include questions about being “depressed,” are routinely used to evaluate depression in clinical practice and have been developed and validated in patients with chronic physical disease (24-26). Moreover, patient-reported comorbidity has been well validated and is more reliable than physician-reported information, particularly for depression (6,7,27,28), and several studies have used these measures to assess the impact of depression in RA patients (7,20,22,29). Given the burden of longer screening instruments in busy practice sites, these measures are feasible alternatives that provide valuable clinical information (24,30).…”

Section: Methodsmentioning

confidence: 99%

A Prospective Evaluation of the Effects of Prevalent Depressive Symptoms on Disease Activity in Rheumatoid Arthritis Patients Treated With Biologic Response Modifiers

Rathbun

Harrold

Reed

2016

Clinical Therapeutics

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Purpose Depressive symptoms are common in rheumatoid arthritis (RA) and may impact disease activity and treatment outcomes. The objective was to determine if prevalent depressive symptoms modify biologic treatment response through their effect on RA disease activity. Methods RA patients with depressive symptoms, initiating biologic treatment, were identified from an American RA registry sample. Depressed patients were compared to controls, patients without reports of depressive symptoms at, or prior to, initiating therapy, regarding CDAI remission and low disease activity (LDA), and the changes in the component measures that comprise this scale at 6 and 12 months follow-up. Inverse probability weighting was used to account for differences in baseline disease severity, concomitant treatment characteristics, and other possible confounders. Logistic and linear regression models estimated differences in response rates and changes in component disease activity measures. Findings Depressive symptoms were associated with a decreased likelihood of CDAI remission at 6 months (OR=0.43; 95% CI: 0.19, 0.96) but not 12 months (OR=0.83; 95% CI: 0.43, 1.60), and there was no effect on CDAI LDA. Adjusted core component measurement changes showed smaller decreases in global assessment ratings in patients with depressive symptoms, yet these associations were not statistically significant. Implications Poorer treatment outcomes among RA patients with depressive symptoms may be a result of higher baseline disease severity. Adjusted estimates indicated symptoms of depression only impacted remission at 6 months follow-up through patient and physician global assessments. Thus, any impact of depressive symptomology during biologic treatment might not due to a definitive impact on joint swelling and tenderness.

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“…Likewise, physicians who suffer from untreated depression are unable to effectively screen, diagnose, and treat depression in their patients. Studies have consistently cited that 25 to 60 percent of depressed patients are not properly screened or diagnosed [9,10].…”

mentioning

confidence: 99%

Physician Depression and Suicide

2003

AMA Journal of Ethics

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Journal of the American Medical Association recently published a consensus statement on physician depression and suicide developed during a workshop sponsored by the American Foundation for Suicide Prevention [1]. The statement's 15 authors (11 of them MDs) urged physicians, medical institutions, and health organizations to give more attention to the treatment of depression and prevention of suicide among physicians. Hendin (the corresponding author) et al contend that attention to physician depression and suicide is long overdue and point to the culture of medicine and the lack of a supportive environment for physicians with mental illness as part of the problem. The authors call for a shift in professional attitudes and institutional policies to encourage physicians to seek help and obtain treatment for mental illness.

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Following Depression in Primary Care: Do Family Practice Physicians Ask About Depression at Different Rates Than Internal Medicine Physicians?

Abstract: Family practice physicians may be more attentive to depressive disorders than internal medicine physicians.

Cited by 13 publications

References 16 publications

Perceived preparedness to provide preventive counseling

Perceived preparedness to provide preventive counseling

A Prospective Evaluation of the Effects of Prevalent Depressive Symptoms on Disease Activity in Rheumatoid Arthritis Patients Treated With Biologic Response Modifiers

Physician Depression and Suicide

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