Primary care Physicians’ perspective on the management of anxiety and depressive disorders: a cross-sectional survey in Emilia Romagna Region

Abstract

BackgroundEvidences from literature suggest that Primary Care Physicians’ (PCPs) knowledge and attitude about psychological and pharmacological treatments of anxiety and depressive disorders could influence their clinical practice. The aim of the study is double: 1) to assess PCPs’ opinions about antidepressants (ADs) and psychotherapy for the management of anxiety and depressive disorders; 2) to evaluate the influence of PCPs’ gender, age, duration of clinical practice, and office location on their opinions and attitudes.MethodsThis cross-sectional multicentre survey involved 816 PCPs working in four Local Health Units of the Emilia Romagna Region. Participating PCPs were asked to complete a questionnaire during educational meetings between October 2006 and December 2008.ResultsThe response rate was 65.1%. Eighty-five percent of PCPs agreed on the effectiveness of ADs for depressive disorder whereas lower agreement emerged for anxiety disorder and on psychotherapy for both anxiety and depression. Forty percent of PCPs reported to feel “very/extremely confident” in recognizing depression and 20.0% felt equally confident in treating it with pharmacotherapy. Considering anxiety disorder, these proportions increased. Female PCPs and those located in the rural/mountain areas reported to adopt more psycho-educational support compared to male and suburban colleagues.ConclusionsOur results suggest that an effort should be made to better disseminate recent evidences about the management of anxiety and depressive disorders in Primary Care. In particular, the importance of psychological interventions and the role of drugs for anxiety disorder should be addressed.

Knowledge, Attitude and Practice Concerning Depression Amongst General Practitioners in Hyderabad.

“…All questions were answered from all participants, who were very interested and highly motivated to participate in the survey and very eager to give answers to questions. The overall response rate of this study was 94% which is much more as compared with 59.4%, and 69% 43, 44 and 45 10,11,12 in studies of similar kind and more than reported in studies 46, 47 13,14 and in which the response rates were 83% and 84.17%. A high proportion of G.Ps were of age 36 to 40 years and the lowest proportion was >50 years age group while majority of G.Ps who participated in this study were male (67.6%).…”

“…Majority 45% of respondents reported that they usually prescribe a combination therapy for the management of their patients with severe depression. Higher findings were reported by several studies 13,14,15,18,19 .…”

ICD-10-Coding of Medically Unexplained Physical Symptoms and Somatoform Disorders—A Survey With German GPs

“…Our study adds some insights into why GPs may not use ICD codes in the way they are expected to. Other studies find GPs' characteristics such as age, experience, working in individual or group practice and area of residence to be relevant for the way physicians handle patients with mental disorders, need for sedatives and chronic pain ( 22 – 26 , 28 , 29 , 49 ). In contrast, we could not find any of these variables, apart from perceived exposure, knowledge of guidelines and experiences as a GP, to influence GPs subjective accounts of their handling of coding MUPS and somatoform disorders.…”

“…Eisenberg sees diagnosis and treatment as a social act influenced by a physicians' character(istics) and patient variables (21). The attitudes of primary care providers towards mental disorders, the way they deal with them and their subjective competencies may differ according to gender, age, training years, years of experience, location of the practice (22)(23)(24)(25)(26) and beliefs about the disorder and subjective ability to offer help or treatment (27). Treatment decisions in chronic pain care appear to depend on the experience of providers (28) while preferences for diagnoses (29) depend mainly on physicians' specialty.…”

The crisis in psychiatry: A public health perspective

“…Psychiatry is not perceived as a medical discipline among medical students, and generally speaking, our specialism is not considered as prestigious as other medical specialisms (Bhugra, 2013;Casini et al, 2013). This could probably be due to the perceived lack of intellectual challenges, doubts about the effectiveness of psychiatric treatments, and a perceived lack of a coherent theoretical basis (Fiorillo et al, 2013a).…”