Study reflects skills in identifying, treating depression -- March 1999 -- FP Report

FP Report -- March 1999

Study reflects skills in identifying, treating depression

An ongoing study reflects the skills and perceptions of family physicians, general internists and OB-Gyns in diagnosing and treating depression.

Managing patients with depression

Characteristic* FPs
General
internists OB-
Gyns

Feel responsible for treating depression 88% 73% 41%

Confident in diagnosis 95% 92% 80%

Confident in overall management 83% 64% 34%

Confident in treating depression

-- with counseling 36% 25% 19%

-- with medication 91% 75% 44%

Know diagnostic criteria well 84% 81% 56%

Assess for sexual or physical abuse 24% 25% 49%

Assess for suicide by direct questions 65% 52% 48%

*Self-assessments reported in January/February Archives of Family Medicine.

Family physicians shine in most elements of the report in the January/February Archives of Family Medicine (see table).

"Family physicians practice a high standard of medical care, compatible with experts' guidelines on depression," said family physician Allen Dietrich, M.D., of the community and family medicine department of Dartmouth Medical School in Hanover, N.H.

Dietrich, a co-author, said, "The study speaks well for our specialty. It's to the credit of the people who founded family practice that they stressed the centrality of behavioral and psychosocial issues. We're 10 years ahead of internists and OB-Gyns in this area."

Dietrich, however, noted that FPs, internists and OB-Gyns lack confidence in treating depression with counseling, suggesting the importance of mental health referrals or more training in counseling.

Dietrich also said all three groups of physicians need to improve in assessing depressed patients for sexual or physical abuse and asking them direct questions about suicide.

The report -- analyzing a survey of 621 FPs, 474 general internists and 255 OB-Gyns -- is "Primary Care Physicians' Approach to Depressive Disorders: Effects of Physician Specialty and Practice Structure."

FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.

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