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The clinical management of a patient with depressive disorder: a case vignette study to examine general practitioners' views

Paterson Centre for Mental Health, 20 South Wharf Road, London W2 1EE

Christine Wright, CSAG Research Assistant and Paul Lelliott, Director

Royal College of Psychiatrists' Research Unit

Declaration of interest

None.

AIMS AND METHOD

The study aimed to examine general practitioner (GP) views about the appropriate management of a patient with a depressive disorder. A questionnaire based around a patient case history was sent to 188 GPs from 11 primary care groups nationally.

RESULTS

The response rate was 62%. At first presentation, a third of GPs offered ‘watchful waiting’ and a third prescribed medication. If the patient's condition deteriorated, nearly all GPs initiated therapeutic doses of antidepressant medication immediately. If the patient failed to respond, 60% of GPs commenced second-line antidepressant treatment. Following recovery, a quarter of GPs would continue antidepressant treatment for 4 months or more.

CLINICAL IMPLICATIONS

GPs' interventions in the management of depression concur with expert national guidelines. There is scope for strengthening the effectiveness of pharmacological intervention in the later stages of treatment.