The attitudes and beliefs of Pakistani medical practitioners about depression: a cross-sectional study in Lahore using the Revised Depression Attitude Questionnaire (R-DAQ)

Abstract

BackgroundMental disorders such as depression are common and rank as major contributors to the global burden of disease. Condition recognition and subsequent management of depression is variable and influenced by the attitudes and beliefs of clinicians as well as those of patients. Most studies examining health professionals’ attitudes have been conducted in Western nations; this study explores beliefs and attitudes about depression among doctors working in Lahore, Pakistan.MethodsA cross-sectional survey conducted in 2015 used a questionnaire concerning demographics, education in psychiatry, beliefs about depression causes, and attitudes about depression using the Revised Depression Attitude Questionnaire (R-DAQ). A convenience sample of 700 non-psychiatrist medical practitioners based in six hospitals in Lahore was approached to participate in the survey.ResultsSix hundred and one (86 %) of the doctors approached consented to participate; almost all respondents (99 %) endorsed one of various biopsychosocial causes of depression (38 to 79 % for particular causes), and 37 % (between 13 and 19 % for particular causes) noted that supernatural forces could be responsible. Supernatural causes were more commonly held by female doctors, those working in rural settings, and those with greater psychiatry specialist education. Attitudes to depression were mostly less confident or optimistic and less inclined to a generalist perspective than those of clinicians in the UK or European nations, and deterministic perspectives that depression is a natural part of aging or due to personal failings were particularly common. However, there was substantial confidence in the efficacy of antidepressants and psychological therapy. More confident and therapeutically optimistic views and a more generalist perspective about depression management were associated with a rejection of supernatural explanations of the origin of depression.ConclusionsNon-psychiatrist medical practitioners in Pakistan hold a range of views about the causes of depression, with supernatural explanations held by more than a third. Depression attitudes appear less positive than among UK and European clinicians, with the notions that depression is due to a lack of stamina and will-power and a natural part of growing old being especially commonly held; more positive attitudes appear to be associated with a rejection of supernatural explanatory models of depression.

Knowledge, attitudes and practices regarding depression among primary health care providers in Fako division, Cameroon

“…Most of the respondents believed that depression is caused by misfortune. Similar findings have been reported elsewhere [ 20 , 30 ]. Discriminatory attitudes and stigma towards depression has been shown to limit depressed patients to seek help [ 7 , 31 ].…”

The psychometric characteristics of the revised depression attitude questionnaire (R-DAQ) in Pakistani medical practitioners: a cross-sectional study of doctors in Lahore

“…This study aimed to examine the psychometric characteristics of the R-DAQ when used by medical practitioners in Pakistan by comparing the factor structure and measures of internal consistency with the findings of the UK development study, as well as between selected (‘known’) groups within this sample based on involvement in psychiatry training or professional development. The findings reported in this paper compliment the analysis of relationships between participant characteristics including casual attributions for depression, and depression attitudes, that are fully provided in a further paper [ 27 ].…”

“…A single self-report questionnaire was used consisting of the R- DAQ scale [ 25 ]; questions concerning participant demographics and medical specialism education and training; and items relating to the possible causes of depression based on a format previously used in a study of university students views about mental illness [ 20 ]. Findings concerning the relationships between casual attributions for depression and attitudes measured by the R-DAQ are reported in a further paper [ 27 ].…”

Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

“…Therefore, social support acts as a mediator, buffering the harmful effects of stressful events on depression. A number of studies have been conducted on the prevalence of psychiatric symptomatology among healthcare students in Pakistan (Ahmad et al, 2015;Haddad et al, 2017Haddad et al, , 2016Waqas et al, 2016Waqas et al, , 2015bWaqas et al, , 2015aWaqas et al, , 2015c. However, none of these have focused on elucidating social support patterns and its buffering effects on depressive symptomatology, thus, warranting this study.…”