[Diagnosis and treatment of depression in general practice. A questionnaire study].

INTRODUCTION: The purpose of this questionnaire study was to assess the knowledge and attitude of general practitioners (GPs) towards the use of diagnostic criteria in clinical practice, and the extent to which diagnostic tools are used as a prerequisite for the treatment of depressive patients in general practice.

MATERIAL AND METHODS: A total of 758 out of 1,700 randomly selected GPs responded to the questionnaire. The GPs' demographic data (age, sex, number of years in practice, supplementary education), diagnostic practice (knowledge of depressive core symptoms and diagnostic tools and scales), and clinical practice (assessment of the effectiveness of treatment, duration of treatment, aim of treatment, and use of psychotherapy) were registered.

RESULTS: The study showed that GPs, who had taken part in supplementary training in psychiatric issues within the preceding year, to a higher extent than the rest of the GPs used diagnostic tools for all or most patients. This group of GPs also had a significantly greater knowledge of the depressive core symptoms as described in the ICD-10. When compared with the other group of GPs, they also felt themselves more confident of the diagnosis of depression before prescribing antidepressive medication. The vast majority of both groups felt that many depressive patients remained undiagnosed, because they simply do not consult their GPs. They also found that it was often questionable whether the symptoms were caused by life crisis or depression--and whether or not the depressive symptoms of these patients required drug treatment.

DISCUSSION: The questionnaire study shows that the GPs' level of knowledge of diagnostics of depression is insufficient. There is an obvious need for supplementary training in general practice, thereby increasing the knowledge and the use of diagnostic criteria in order to make diagnoses of depression more correct and to improve treatment.