Hilmi Atalıç, Ali Can


Depression is a widespread disease and remarks a difficult clinical challenge for primary health care providers or physicians. Primary health care providers, namely Family Physicians (FPs), are crucial in recognizing and managing depression process. The study employed a cross-sectional survey of FPs’ attitudes toward diagnosis and management, asking about their perceptions of their patient depression process. Data for the study was gathered from the FPs who were Facebook group members. 229 out of 550 FPs answered the survey questions. Statistical analysis was conducted using SPSS 24th edition. The study examined whether FPs made a significant difference between gender and years of experience in the profession. A questionnaire comprising items on a 9-point Likert scale was used to capture the perceptions and the data was analyzed using descriptive statistics and t-tests. Analysis of variance (ANOVA) was further employed to examine if the critical factors were perceived differently by FPs’ experience years. The study findings presented that gender did not make a statistically significant difference. There was a significant difference between the 6-10 years of experience group of FPs, the 16-20 years of experience group, and the 21+ years group. The study showed that FPs were undecided in diagnosing and treating depressed patients. The study displayed that FPs' getting to know their patients better facilitates the diagnosis and treatment of depression. However, the study indicated that family physicians were indecisive in the depressed patients' diagnosis and treatment. It can be concluded that the success of depression processes requires the cooperation of FPs and psychiatrists. These findings suggest that healthcare policymakers should consider FPs' strategies for managing depression in the improvement of mental health services.


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depression, family physicians, diagnosis and treatment motivation

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Alanazi, Abdulaziz; Alsharif, Saad; Alzahrani, Ziyad; Alanazi, Ahmed. Knowledge and practice of depression management among primary healthcare physicians. Journal of Family Medicine and Primary Care 11(6):p 2442-2447, June 2022. | DOI: 10.4103/jfmpc.jfmpc_2083_21

Al Quwaidhi A, Al Sarhan M, Al Rofaiae H, Al Jabr Q. Primary Health-Care Physicians Attitude toward Depression in Primary Health-Care Centers Saudi Arabia - Al-Ahsa, 2018. Int J Sci Stud 2018;6(8):6-14.

Annette S. Davidsen & Christina F. Fosgerau (2014) What is depression? Psychiatrists’ and GPs’ experiences of diagnosis and the diagnostic process, International Journal of Qualitative Studies on Health and Well-being, 9:1, 24866, DOI: 10.3402/qhw.v9.24866

Aragonès E, Piñol JL, Caballero A, López-Cortacans G, Casaus P, Hernández JM, Badia W, Folch S. Effectiveness of a multi-component programme for managing depression in primary care: a cluster randomized trial. The INDI project. J Affect Disord. 2012 Dec 15;142(1-3):297-305. doi: 10.1016/j.jad.2012.05.020. Epub 2012 Oct 11. PMID: 23062747.

Bilsker D, Goldner EM, Jones W. Health service patterns indicate potential benefit of supported self-management for depression in primary care. Can J Psychiatry. 2007 Feb;52(2):86-95. doi: 10.1177/070674370705200203. PMID: 17375863.

Broers T, Hodgetts G, Batić-Mujanović O, Petrović V, Hasanagić M, Godwin M. Prevalence of mental and social disorders in adults attending primary care centers in Bosnia and Herzegovina. Croat Med J. 2006 Jun;47(3):478-84. PMID: 16758527; PMCID: PMC2080429.

Cabana MD, Rushton JL, Rush AJ. Implementing practice guidelines for depression: applying a new framework to an old problem. Gen Hosp Psychiatry. 2002 Jan-Feb;24(1):35-42. doi: 10.1016/s0163-8343(01)00169-4. PMID: 11814532.

Clatney L, Macdonald H, Shah SM. Mental health care in the primary care setting: family physicians' perspectives. Can Fam Physician. 2008 Jun;54(6):884-9. PMID: 18556498; PMCID: PMC2426969.

Davidsen AS, Fosgerau CF. What is depression? Psychiatrists' and GPs' experiences of diagnosis and the diagnostic process. Int J Qual Stud Health Well-being. 2014 Nov 6;9:24866. doi: 10.3402/qhw.v9.24866. PMID: 25381757; PMCID: PMC4224702.

Gallo JJ, Meredith LS, Gonzales J, Cooper LA, Nutting P, Ford DE, Rubenstein L, Rost K, Wells KB; Quality Improvement for Depression Consortium. Do family physicians and internists differ in knowledge, attitudes, and self-reported approaches for depression? Int J Psychiatry Med. 2002;32(1):1-20. doi: 10.2190/7QNE-ENF5-2KEL-723X. PMID: 12075912.

Harman JS, Brown EL, Have TT, Mulsant BH, Brown G, Bruce ML. Primary care physicians attitude toward diagnosis and treatment of late-life depression. CNS Spectr. 2002 Nov;7(11):784-90. doi: 10.1017/s1092852900024299. PMID: 12947240

Hudon, C., St-Cyr Tribble, D., Bravo, G. et al. Family physician enabling attitudes: a qualitative study of patient perceptions. BMC Fam Pract 14, 8 (2013).

Isabelle Schumann, Antonius Schneider, Claudia Kantert, Bernd Löwe, Klaus Linde, Physicians’ attitudes, diagnostic process and barriers regarding depression diagnosis in primary care: a systematic review of qualitative studies, Family Practice, Volume 29, Issue 3, June 2012, Pages 255–263,

Josephine Anderson, Verònica Gálvez, Colleen K Loo, Philip B Mitchell, November 2015, Adult depression: a step-by-step guide to treatment,

Kerr M, Blizard R, Mann A. General practitioners and psychiatrists: comparison of attitudes to depression using the depression attitude questionnaire. Br J Gen Pract. 1995 Feb;45(391):89-92. PMID: 7702889; PMCID: PMC1239142.

Leff MS, Vrubļevska J, Lūse A, Rancāns E. Latvian family physicians' experience diagnosing depression in somatically presenting depression patients: A qualitative study. Eur J Gen Pract. 2017 Dec;23(1):91-97. doi: 10.1080/13814788.2017.1291626. PMID: 28326860; PMCID: PMC5774294.

Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Sci Rep. 2018 Feb 12;8(1):2861. doi: 10.1038/s41598-018-21243-x. Erratum in: Sci Rep. 2022 Sep 1;12(1):14856. PMID: 29434331; PMCID: PMC5809481.

Liu SI, Lu RB, Lee MB. Non-psychiatric physicians' knowledge, attitudes and behavior toward depression. J Formos Med Assoc. 2008 Dec;107(12):921-31. doi: 10.1016/S0929-6646(09)60015-2. PMID: 19129052.

MacCarthy D, Weinerman R, Kallstrom L, Kadlec H, Hollander MJ, Patten S. Mental health practice and attitudes of family physicians can be changed! Perm J. 2013 Summer;17(3):14-7. doi: 10.7812/TPP/13-033. PMID: 24355885; PMCID: PMC3783077.

Maurer DM, Raymond TJ, Davis BN. Depression: Screening and Diagnosis. Am Fam Physician. 2018 Oct 15;98(8):508-515. PMID: 30277728.

McNaughton JL. Brief interventions for depression in primary care: a systematic review. Can Fam Physician. 2009 Aug;55(8):789-96. PMID: 19675262; PMCID: PMC2726093.

Mulango, I.D., Atashili, J., Gaynes, B.N. et al. Knowledge, attitudes and practices regarding depression among primary health care providers in Fako division, Cameroon. BMC Psychiatry 18, 66 (2018).

Ohtsuki T, Kodaka M, Sakai R, Ishikura F, Watanabe Y, Mann A, Haddad M, Yamada M, Inagaki M. Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study. BMC Res Notes. 2012 Aug 16;5:441. doi: 10.1186/1756-0500-5-441. PMID: 22894761; PMCID: PMC3434090.

Oöpik P, Aluoja A, Kalda R, Maaroos HI. Family doctors' problems and motivating factors in management of depression. BMC Fam Pract. 2006 Oct 30;7:64. doi: 10.1186/1471-2296-7-64. PMID: 17074079; PMCID: PMC1635052.

Park LT, Zarate CA Jr. Depression in the Primary Care Setting. N Engl J Med. 2019 Feb 7;380(6):559-568. doi: 10.1056/NEJMcp1712493. PMID: 30726688; PMCID: PMC6727965.

Pettersson A, Modin S, Wahlström R, Af Winklerfelt Hammarberg S, Krakau I. The Mini-International Neuropsychiatric Interview is useful and well-accepted as part of the clinical assessment for depression and anxiety in primary care: a mixed-methods study. BMC Fam Pract. 2018 Jan 24;19(1):19. doi: 10.1186/s12875-017-0674-5. PMID: 29368585; PMCID: PMC5781342.

Ricardo Manzanera, Guillermo Lahera, Miguel Ángel Álvarez-Mon, Melchor Alvarez-Mon, Maintained effect of a training program on attitudes towards depression in family physicians, Family Practice, Volume 35, Issue 1, February 2018, Pages 61–66,

S.-I. Liu, R.-B. Lu, M.-B. Lee Non-psychiatric physicians' knowledge, attitudes and behavior toward depression J Formos Med Assoc, 107 (12) (2008), pp. 921-931

van der Feltz-Cornelis CM, Van Os TW, Van Marwijk HW, Leentjens AF. Effect of psychiatric consultation models in primary care. A systematic review and meta-analysis of randomized clinical trials. J Psychosom Res. 2010 Jun;68(6):521-33. doi: 10.1016/j.jpsychores.2009.10.012. Epub 2010 Jan 15. PMID: 20488268.

van Rijswijk E, van Hout H, van de Lisdonk E, Zitman F, van Weel C. Barriers in recognising, diagnosing and managing depressive and anxiety disorders as experienced by Family Physicians; a focus group study. BMC Fam Pract. 2009 Jul 20;10:52. doi: 10.1186/1471-2296-10-52. PMID: 19619278; PMCID: PMC2734533.

Vinogradova, Vineta Viktorija, Vrubļevska, Jeļena and Rancāns, Elmārs. "Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression" Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences., vol.73, no.2, 2019, pp.164-170.

Warmenhoven F, van Rijswijk E, van Hoogstraten E, van Spaendonck K, Lucassen P, Prins J, Vissers K, van Weel C. How family physicians address diagnosis and management of depression in palliative care patients. Ann Fam Med. 2012 Jul-Aug;10(4):330-6. doi: 10.1370/afm.1373. PMID: 22778121; PMCID: PMC3392292.

WONCA Asia Pacific Conference, Family doctors’ role in providing non-drug interventions (NDIs) for common mental health disorders in primary care, Pattaya, Thailand, 1-4 November 2017.

Yaffe MJ, Primeau F, McCusker J, Cole MG, Belzile E, Dendukuri N, Elie M, Laplante J. Psychiatric outpatient consultation for seniors. Perspectives of family physicians, consultants, and patients/family: a descriptive study. BMC Fam Pract. 2005 Apr 19;6(1):15. doi: 10.1186/1471-2296-6-15. PMID: 15840163; PMCID: PMC1090569

Yıldız Y, Sunay D, Akkuş M (2018). Aile Hekimliği Uzmanlarının Depresyon Tedavisine Bakışı. Bilişsel Davranışçı Psikoterapi ve Araştırmalar Dergisi, 7(2), 62 - 71. 10.5455/JCBPR.275495



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