Factors in the awareness of depression, focusing on perceptual dissimilarities between PCPs and patients: an exploratory and qualitative research.

Abstract

Primary care physicians (PCPs) are said to play a leading role in the early diagnosis of depression. Sometimes however, symptoms can be overlooked or misdiagnoses may occur, and this may be due to differences in the way that PCPs and patients perceive depression. The aim of this study is to clarify factors that may contribute to suspicions, or awareness of depression, focusing especially on perceptual dissimilarities between PCPs and patients. We conducted our research using qualitative methodology, with individual interviews being conducted with five experienced primary care physicians working in a rural area, and five patients who had been in consultation with PCPs. The main interview topic of this study was the triggers for their, or their patients', depression. From our interviews we discerned five categories of factors: "mental manifestations," "physical manifestations," "events in the patient's private life," "social environment and conditions" and "others." Our findings suggest that a critical difference in the perception of depression may exist between PCPs and patients. PCPs should be more alert to uncommon conditions of depression, as well as the more prevalent symptoms. We found that PCP's latent abilities and attitudes, such as "intuition," "subjectivity," and "experience", are often cues in the diagnosis of depression. This is in accordance with existing research on the subject. On the patients' side, sometimes sufferers do not notice the symptoms of depression by themselves, which may also be a serious problem. In conclusion, we, as medical professionals, must take care to be aware of these distinctions in order to swiftly detect depression, and to better treat our patients.