name:ahmed wazer Nov 2012
category: Gps General charctaristic
BACKGROUND:
Despite its public health significance, data about depression in general practice are often unavailable.
OBJECTIVE:
To
study (i) the incidence of GP-diagnosed depression during 2008, (ii)
associations between patient characteristics, appraised severity and
initiated treatment, (iii) GPs' usual care compared to diagnostic
criteria from Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition guidelines and the newly developed practice guideline of
the Society of Flemish GPs (2008) and (iv) GPs' initiated treatments
compared to the Flemish Guideline.
METHODS:
General
practice-based data were collected on all patients of ≥18 years who were
diagnosed by their GP with a new episode of depression in Belgian
sentinel general practices (SGP) during 2008.
RESULTS:
Data
on 1739 persons were recorded by 172 sentinel general practices.
Incidence rates for GP-diagnosed depression were estimated at
719/100 000 men and 1440/100 000 women. Thirty-one per cent of patients
had mild, 50% had moderate and 19% had severe GP-diagnosed depression.
Although only 43% of the patients at risk for suicide were considered to
have severe depression, having thoughts of death or suicide was the
main factor associated with increased severity of depression.
Seventy-five per cent of patients received a prescription for an
antidepressive agent; 29% received a prescription for another
psychoactive agent; in 36%, non-pharmaceutical support was initiated by
the GP and 25% received a referral. In contrast with the Flemish GP
guideline criteria: (i) 69% of patients with a new episode of mild or a
first episode of moderate depression were prescribed an antidepressive
agent and (ii) only 39% of the patients with severe depression were both
prescribed an antidepressive agent and referred to a mental health
service.
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