Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.
Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., Vollebergh, W. A. M. (2004). Prevalence of mental disorders in Europe: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr. Scandin., 109 (420), 21–27.
Andriopoulos, P., Lotti-Lykousa, M., Pappa, E., Papadopoulos, A. A., Niakas, D. (2013). Depression, quality of life and primary care: A cross-sectional study. J. Epidemiol. Global Health, 3 (4), 245–252.
Ani, C., Bazargan, M., Hindman, D., Bell, D., Farooq, M. A., Akhanjee, L., Rodriguez, M. (2008). Depression symptomatology and diagnosis: Discordance between patients and physicians in primary care settings. BMC Fam. Pract., 9, 1–9.
Archer, J., Bower, P., Gilbody, S., Lovell, K., Richards, D., Gask, L., Dickens, C., Coventry, P. (2012). Collaborative care for depression and anxiety problems. Cochrane Database Syst. Rev., 10, CD006525
Baik, S.-Y., Gonzales, J. J., Bowers, B. J., Anthony, J. S., Tidjani, B., Susman, J. L. (2010). Reinvention of depression instruments by primary care clinicians. Ann. Fam. Med.,8 (3), 224–230.
Bajracharya, P., Summers, L., Amatya, A. K., DeBlieck, C. (2016). Implementation of a depression screening protocol and tools to improve screening for depression in patients with diabetes in the primary care setting. J. Nurse Pract., 12 (10), 690–696.
Bishop, T. F., Ramsay, P. P., Casalino, L. P., Bao, Y., Pincus, H. A. (2016). Care management processes used less often for depression than for other chronic conditions in US primary care practices. Health Affairs, 35 (3), 394–400.
Bertakis, K. D. (2009). The influence of gender on the doctor-patient interaction. Patient Ed. Couns., 76 (3), 356–360.
Bock, J.-O., Luppa, M., Brettschneider, C., Riedel-Heller, S., Bickel, H., Fuchs, A., König, H.-H. (2014). Impact of depression on health care utilization and costs among multimorbid patients: Results from the MultiCare Cohort Study. PLoS ONE, 9 (3), e91973.
Bortolotti, B., Menchetti, M., Bellini, F., Montaguti, M. B., Berardi, D. (2008). Psychological interventions for major depression in primary care: A meta-analytic review of randomized controlled trials. Gen. Hospit. Psychiatry, 30 (4), 293–302.
Clarke, D. M., Currie, K. C. (2009). Depression, anxiety and their relationship with chronic diseases: A review of the epidemiology, risk and treatment evidence. Med. J. Austral., 190 (7), 54–60.
Craven, M. A., Bland, R. (2013). Depression in primary care: Current and future challenges. Can. J. Psychiatry, 58 (8), 442–448.
Cuijpers, P., Vogelzangs, N., Twisk, J., Kleiboer, A., Li, J., Penninx, B. W. (2013). Differential mortality rates in major and subthreshold depression: Meta-analysis of studies that measured both. Brit. J. Psychiatry, 202 (1), 22–27.
Dumesnil, H., Cortaredona, S., Verdoux, H., Sebbah, R., Paraponaris, A., Verger, P. (2012). General practitioners’ choices and their determinants when starting treatment for major depression: A cross sectional, randomized case-vignette survey. PLoS ONE, 7 (12), e52429.
Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Pike, C. T., Kessler, R. C. (2015). The Economic burden of adults with major depressive disorder in the United States (2005 and 2010). J. Clin. Psychiatry,76 (2), 155–162.
Hall, J. A., Irish, J. T., Roter, D. L., Ehrlich, C. M., Miller, L. H. (1994). Gender in medical encounters: An analysis of physician and patient communication in a primary care setting. Health Psychology, 13 (5), 384–392.
Honigfeld, L., Macary, S. J., Grasso, D. J. (2017). A clinical care algorithmic toolkit for promoting screening and next-level assessment of pediatric depression and anxiety in primary care. J. Pediatric Health Care,31 (3), e15–e23.
Ivanovs, R., Kivite, A., Ziedonis, D., Mintale, I., Vrublevska, J., Rancans, E. (2018). Association of depression and anxiety with the 10-year risk of cardiovascular mortality in a primary care population of Latvia using the SCORE system. Frontiers in Psychiatry, 9, 276.
Katon, W., Schulberg, H. (1992). Epidemiology of depression in primary care. Gen. Hospit. Psychiatry, 14 (4), 237–247.
Kendrick, T., King, F., Albertella, L., Smith. (2005). GP treatment decisions for patients with depression: An observational study. Brit. J. Gen. Pract.,55 (513), 280–286.
Leff, M. S., Vrubïevska, J., Lūse, A., Rancāns, E. (2017). Latvian family physicians’ experience diagnosing depression in somatically presenting depression patients: A qualitative study. Eur. J. Gen. Pract., 23 (1), 91–97.
Lynch, J. R., Berg, S. T., Manna, J., Schade, C. P. (2016). Making a dent in undiagnosed and untreated depression among older West Virginians. West Virginia Med. J.,112 (3), 60–66.
Luppa, M., Sikorski, C., Motzek, T., Konnopka, A., König, H., Riedel-Heller, S. (2012). Health service utilization and costs of depression in late life: A systematic review. Curr. Pharmaceut. Design, 18 (36), 5936–5957.
Moussavi, S., Chatterji, S. (2007). Depression, chronic diseases, and decrements in health: Results from the World Health Surveys. Lancet, 370, 851–858.
Ng, C. W. M., How, C. H., Ng, Y. P. (2017). Managing depression in primary care. Singapore Med. J.,58 (8), 459–466.
Ornstein, S. M., Nietert, P. J., Jenkins, R. G., Litvin, C. B. (2013). The prevalence of chronic diseases and multimorbidity in primary care practice: A PPRNet Report. J. Amer. Board Fam. Med.,26 (5), 518–524.
Puyat, J. H., Kazanjian, A., Goldner, E. M., Wong, H. (2016). How often do individuals with major depression receive minimally adequate treatment? A population-based, data linkage study. Can. J. Psychiatry, 61 (7), 394–404.
Rancans, E., Vrublevska, J., Snikere, S., Koroleva, I., Trapencieris, M. (2014). The point prevalence of depression and associated sociodemographic correlates in the general population of Latvia. J. Affect. Disord., 156, 104–110.
Rancans, E., Trapencieris, M., Ivanovs, R., Vrublevska, J. (2018). Validity of the PHQ-9 and PHQ-2 to screen for depression in nationwide primary care population in Latvia. Ann. Gen. Psychiatry, 17 (1), 33.
Schenker, Y., Stewart, A., Na, B., Whooley, M. A. (2009). Depressive symptoms and perceived doctor-patient communication in the heart and soul study. J. Gen. Intern. Med.,24 (5), 550–556.
Scott, C., Tacchi, M. J., Jones, R., Scott, J. (1997). Acute and one-year outcome of a randomised controlled trial of brief cognitive therapy for major depressive disorder in primary care. Brit. J. Psychiatry, 171, 131–134.
Shvartzman, P., Weiner, Z., Vardy, D., Friger, M., Sherf, M., Biderman, A. (2005). Health services utilization by depressive patients identified by the MINI questionnaire in a primary care setting. Scand. J. Primary Health Care, 23 (1), 18–25.
Sedgwick, P. (2012). What is recall bias? BMJ,344 (7858), 1–2.
Šica, K., Pulmanis, T., Taube, M. (2017). Psihiskā veselība Latvijā 2016. gadā [Mental health in Latvia in 2016]. Slimību kontroles un profilakses centrs, Rīga. 57 lpp. (in Latvian).
Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., Pignone, M. P. (2016). Screening for depression in adults. Jama, 315 (4), 380.
Smith, P. C., Brown Levey, S. M., Lyon, C. (2017). Evaluating transformation with available resources: The influence of APEX on depression screening. Fam. Syst. Health,35 (2), 238–247.
Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., Silove, D. (2014). The global prevalence of common mental disorders: A systematic review and meta-analysis 1980–2013. Int. J. Epidemiol.,43 (2), 476–493.
Tan, M. C. (2018). Depression screening in Asian Americans: A quality improvement project (Order No. 10811726). Available from ProQuest Dissertations & Theses Global: The Sciences and Engineering Collection. (2043390921).
Trautman, S., Beesdo-Baum, K. (2017). Behandlung depressiver Störungen in der primärärztlichen Versorgung. Deutsches Arzteblatt International, 114 (43), 721–728.
Unützer, J., Park, M. (2012). Strategies to improve the management of depression in primary care. Primary Care Clin. Off. Pract., 39 (2), 415–431.
Van Rijswijk, E., Van Hout, H., Van De Lisdonk, E., Zitman, F., Van Weel, C. (2009). Barriers in recognising, diagnosing and managing depressive and anxiety disorders as experienced by Family Physicians; A focus group study. BMC Fam. Pract., 10, 1–7.
Verdoux, H., Cortaredona, S., Dumesnil, H., Sebbah, R., Verger, P. (2014). Psychotherapy for depression in primary care: A panel survey of general practitioners’ opinion and prescribing practice. Soc. Psychiatry Psychiatric Epidemiol., 49 (1), 59–68.
Vos, T., Allen, C., Arora, M., Barber, R. M., Brown, A., Carter, A., Zuhlke, L. J. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388 (10053), 1545–1602.
Vrublevska, J., Trapencieris, M., Snikere, S., Grinberga, D., Velika, B., Pudule, I., Rancans, E. (2017). The 12-month prevalence of depression and health care utilization in the general population of Latvia. J. Affect. Disord.,210, 204–210.
Yang, M., Loeb, D. F., Sprowell, A. J., Trinkley, K. E. (2019). Design and implementation of a Depression Registry for Primary Care. Amer. J. Med. Qual.,34 (1), 59–66.