TY - JOUR
KW - Catchment Area (Health)
KW - Clinical Competence
KW - Cognition Disorders/diagnosis/epidemiology
KW - Depressive Disorder, Major/diagnosis/drug therapy/epidemiology
KW - Diagnosis, Differential
KW - Diagnostic and Statistical Manual of Mental Disorders
KW - Epidemiologic Studies
KW - Female
KW - Guidelines as Topic
KW - Humans
KW - Male
KW - Mental Health Services/standards
KW - Middle Aged
KW - Neuropsychological Tests
KW - Primary Health Care/methods/statistics & numerical data
KW - Questionnaires
KW - Recognition (Psychology)
KW - Sampling Studies
KW - Severity of Illness Index
KW - Spain/epidemiology
KW - Treatment Outcome
AU - A. Fernandez
AU - A. Pinto-Meza
AU - J. A. Bellon
AU - P. Roura-Poch
AU - J. M. Haro
AU - J. Autonell
AU - D. J. Palao
AU - M. T. Penarrubia
AU - R. Fernandez
AU - E. Blanco
AU - J. V. Luciano
AU - A. Serrano-Blanco
A1 - 
AB - 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.
BT - General hospital psychiatry
C5 - Education & Workforce
CP - 2
CY - United States
DO - 10.1016/j.genhosppsych.2009.11.015
IS - 2
JF - General hospital psychiatry
N2 - 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.
PB - Elsevier Inc
PP - United States
PY - 2010
SN - 1873-7714; 0163-8343
SP - 201
EP - 209
EP - 
T1 - Is major depression adequately diagnosed and treated by general practitioners? Results from an epidemiological study
T2 - General hospital psychiatry
TI - Is major depression adequately diagnosed and treated by general practitioners? Results from an epidemiological study
U1 - Education & Workforce
U2 - 20302995
U3 - 10.1016/j.genhosppsych.2009.11.015
VL - 32
VO - 1873-7714; 0163-8343
Y1 - 2010
ER -