Training primary-care physicians to recognize, diagnose and manage depression: does it improve patient outcomes?

Abstract

Training primary-care physicians to recognize, diagnose and manage depression can improve short-term patient outcomes, especially for patients with a recent onset of depression. Patients suffering from a recurrent or chronic depression may need more specific interventions, both for acute treatment and long-term management.

A pragmatic cluster randomized controlled trial of an educational intervention for GPs in the assessment and management of depression

“…General practitioners (GPs) can be provided with effective training in the skills to manage depression (Gask et al 1998;Van Os et al 1999). What remains uncertain is how effective such training may be in producing health gain with some authors reporting positive effects (Rutz et al 1989a(Rutz et al , b, 1992Tiemens et al 1999) and others (Lin et al 1997(Lin et al , 2001; Thompson et al 2000;King et al 2002) minimal or no effect.…”

Rapid aneuploidy detection or karyotyping? Ethical reflection

“…For example, the efficacy of interventions following systematic screening for depression of patients in GPs' practices has been found to be low, probably because the people who are picked up in this way have little need for help because their symptoms are mild and they are likely to recover without intervention. [140][141][142][143] The efficacy of systematic screening for anxiety and alcohol-related disorders has not been established either, and it is not effective at population level. But it is not impossible that written questionnaires could become useful in the future, for example in the diagnosis of people with a suspected mental problem or as an instrument for selective use among high-risk groups.…”

Emotional disorders in primary care.

“…They found improved outcomes at 3 and 6 months, although differences in outcomes were of marginal statistical significance at the 6-month measure. Tiemens et al (1999) implemented a 20-hr training program for primary care physicians on detection, diagnosis, and treatment, finding an initial improvement in short-term outcomes for depressed patients but no effect by 1 year. C. Thompson et al (2000) carried out a randomized, controlled trial of a practice-based educational intervention based on clinical practice guidelines in 60 primary care practices in the United Kingdom and found no effect on either recognition or clinical outcome.…”