General practitioners' views towards diagnosing and treating depression in five southeastern European countries

Abstract

Aim: To assess and compare general practitioners' (GPs') views of diagnosing and treating depression in five southeastern European countries. Methods:A cross-sectional study was conducted in Albania, Bulgaria, Moldova, Romania, and Serbia. The sample included 467 GPs who completed a hard-copy self-administered questionnaire, consisting of self-assessment questions related to diagnosing and treating depression. Results:The most common barriers to managing depression in general practice reported by GPs were: patients' unwillingness to discuss depressive symptoms (92.3%); appointment time too short to take an adequate history (91.9%), barriers for prescribing appropriate treatment (90.6%); and patients' reluctance to be referred to a psychiatrist (89.1%). Most GPs (78.4%) agreed that recognizing depression was their responsibility, 71.7% were confident in diagnosing depression, but less than one-third (29.6%) considered that they should treat it.Conclusions: Improvements to the organization of mental healthcare in all five countries should consider better training for GPs in depression diagnosis and treatment; the availability of mental healthcare specialists at primary care level, with ensured equal and easy access for all patients; and the removal of potential legal barriers for diagnosis and treatment of depression.

General practitioners’ views towards management of common mental health disorders: Τhe critical role of continuing medical education

“…Regarding therapeutic approach, the percentage of physicians that prescribe medication (56.1%) is significantly lower than that reporting awareness (77.8%) of the appropriate medication for the disease they have diagnosed. In a cross-sectional study from five southeastern European countries, even though 40.9% of GPs state that can treat depression with medication, 79.4% believe patients in need of antidepressants should do better if referred to a psychiatrist [ 22 ]. A questionable therapeutic approach of GPs is highlighted in an Italian study, as 35% from those who initiated treatment, were in fact false-positive cases of depression [ 10 ].…”

“…Close collaboration with mental health specialists, in both training and practice, is of eminent importance. In order to guide an efficient support of mental disorders at the primary healthcare, the following recommendations are deduced from this study, also supported by the literature: i) theoretical learning should be accompanied by practical training, so that education is tied with real clinical practice [ 4 ], ii) an efficient model of outpatient consult liaison psychiatry, like the collaborative care model [ 31 , 32 ] should be developed, that enhances the skills of GPs to manage psychiatric patients, and iii) adequate time for diagnosis, counselling, self-study and consultation should be given to GPs, along with incentives to be deeply involved in the management of mental disorders [ 4 , 7 , 15 , 22 , 33 ].…”

Frequency and correlates of depression at the primary health care level in Belgrade

“…Previous studies have shown that women are more likely to be depressed in countries in which they have lower income, and lower socio-economic status. Women are more likely to be prescribed with more antidepressants than men are, which may be associated with higher prevalence reported [22].…”

“…According to the education and practice in Serbia, general practitioners should be able to recognize the depression and refer the patient to the psychiatry treatment. The study among general practitioners in five Southeastern Europe countries showed that the majority of our general practitioners consider recognizing the depression as their responsibility [22].…”

Differences in Facial Expression Recognition Between Unipolar and Bipolar Depression

“…In 2017, the World Health Organization (WHO) reported that depression, which affects 322 million people globally, is the second leading cause of the World’s medical burden. It is expected that by 2030, depression will become the most common disabling condition ( Duric et al, 2018 ). Depression is a common disease with low mood, lack of interest, fatigue, and other core symptoms.…”