Article Figures & Data
Tables
- Table 1.
Some Examples of Early Interview Questions for the Describing the Enigma of Evaluating Depression Project
What does your typical day look like? When do you start to think that you may have seen mental health issues? Was there any situation in which you missed it the first time, then realized later that it was a mental health issue? How does depression fit in with what you do? What does it take for you to say to yourself, not necessarily to the patient, “this may be depression”? What does it take for you to say to your patient that she or he may be depressed? How do you say it? Have you had a situation in which you felt that a patient was depressed and when you shared your impression, the patient said, “I don’t think so”? I am not a clinician, but I would think it would not be easy for a provider to sort out whether a patient has depression or has a tough life. How do you sort those out? Or do you even need to sort that out to recognize or manage depression? How do you decide which approach or treatment would work for the patient? What do you have to know to decide that? Is there any difference in deciding what to do for one patient vs another? How do you know the treatment that you prescribed is working or not working? What do you do when you see the treatment is not working? How do you know whether the patient is following your treatment? Would you give me an example of an illness with a care process you think may be similar to or different from that of depression? Now would you please walk me through what might make its process similar to or different from that of depression? Can you share with me any experiences that have influenced your approach to depression? What are the challenges that you see in your practice environment to providing mental health care and depression treatment in particular?
Additional Files
The Article in Brief
Reinvention of Depression Instruments by Primary Care Clinicians
Seong-Yi Baik , and colleagues
Background Many instruments have been developed to help diagnose depression and evaluate its treatment. This study looks at how and why primary care clinicians use depression screening instruments in their practices.
What This Study Found Primary care clinicians report using depression-screening instruments when they need to persuade a patient to accept a diagnosis of depression, when they lack time, or when they do not fully understand the patient�s social and relational life. They rarely use depression instruments for screening purposes or for monitoring the treatment of depression.
Implications
- Clinicians have reinvented depression screening instruments to deal with a real-world problem: convincing patients, believed to be depressed, that they are depressed and developing a shared agenda for treatment. This negotiation process is overlooked by current guidelines for depression, yet primary care clinicians see it as one of the greatest burdens they face.
- Additional research is needed to help foster efficient depression care processes for real-world primary care practice.
