Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study

Abstract

BackgroundUnder-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors’ attitude toward depression.MethodsThe inclusion criteria of participants in the present study were as follows: 1) Japanese non-psychiatric doctors and 2) attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1) a workshop to depression care for non-psychiatric doctors and 2) a general physician-psychiatrist (G-P) network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ), a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis.ResultsWe received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187) disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112) agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101) agreed. Meanwhile, 67 % of doctors (n = 126) thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly different to that of British GPs.ConclusionsJapanese non-psychiatric doctors believe that depression care is beyond the scope of their duties. It is suggested that educational programs or guidelines for depression care developed in other countries such as the UK are not directly adaptable for Japanese non-psychiatric doctors. Developing a focused educational program that motivates non-psychiatric doctors to play a role in depression care is necessary to enhance recognition and treatment of depression in Japan.

Attitudes of Indian HIV Clinicians Toward Depression in People Living with HIV

“…There appeared to be considerably less misinformation and stigma about depression in this sample compared to a previous study of Indian non-psychiatric clinicians 20 , which suggests that HIV providers may have been sensitized to the importance of behavioral health. Encouragingly, compared to non-psychiatric clinicians in high-income countries 24,27 , including HIV clinicians in the United States 23 , the Indian HIV providers sampled in our study appeared to endorse to a similar (if not greater) extent favorable attitudes toward PLHIV and a willingness to diagnose and treat depression. We found that these opinions and attitudes were generally held regardless of respondents’ gender, rural vs. urban practice locale, employment in public or private practice, years in practice, or numbers of PLHIV seen per month.…”

“…These 29 items, which were grouped into five categories, asked respondents to agree with statements about depression in PLHIV using a 5-point Likert scale (strongly agree, agree, neutral, disagree, strongly disagree). The questionnaire was adapted from other published questionnaires on provider attitudes toward mental health 23,24 , including two from India 25,26 . Study materials were written in English, which was the primary language used at CART 2015.…”

A questionnaire survey of Japanese non-psychiatrists’ attitudes on management of depression in a general hospital

“…The finding is compatible with a notion that nonpsychiatrists are reluctant to manage patients with depression (Ohtsuki et al, 2010), and they tend to think that treatment of depression is reserved to only psychiatrists (Ohtsuki et al, 2012). Furthermore, they indicated to judge the efficacy of antidepressants in 8.6 days after prescribing them, which is rather hasty in light of the recommended duration of 2-4 weeks in the guidelines (NICE, 2009).…”

“…In Japan, it has been reported that only 7.4% of patients with depression received optimal treatment in a general hospital (Ohtsuki et al, 2010) despite at least equivalent prevalence of depression in medical inpatients compared to those in other countries (21.5% vs. 5.0-21.0%) (Forkmann et al, 2011;Hosaka et al, 1999;Silverstone et al, 1996). This condition may be, at least to some extent, attributable to lack of confidence, recognition, and motivation towards depressive care among non-psychiatrists (Ohtsuki et al, 2010(Ohtsuki et al, , 2012. Moreover, such non-psychiatrists' negative attitude on depression may result in insufficient utility of consultation-liaison psychiatry; however, the attitude on depression among non-psychiatrists in general hospitals remains unclear.…”

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

“…Knowledge among GPs of mental disorders may vary from country to country and depends on the amount and quality of training received both at under‐ and postgraduate levels (James, Jenkins, Lawani, & Omoaregba, ). Developing a focused medical educational program that motivates GPs to play a role in depression care is necessary to enhance recognition and treatment of depression, as suggested, for example, by studies in Japan (Ohtsuki et al, ), France (Mercier et al, ), and Australia (Richards et al, ). However, participation in mental health training by GPs appears to be related to their attitudes towards depressed patients and to their confidence and abilities to diagnose and manage common mental disorders effectively (Williams et al, ).…”