HEALTHPatient beliefs may determine success of depression careA new study says outcomes are poorer in primary care because these patients are less likely to accept treatment.By Victoria Stagg Elliott, amednews staff. Feb. 2, 2004. Michael S. Klinkman, MD, a family physician in Ann Arbor, Mich., knows from experience that patients with depression are often more challenging to treat than those who seek out a psychiatrist or other mental health professional. "In primary care, we have an adverse selection of patients," said Dr. Klinkman, an associate professor at the University of Michigan Health System. "What we're often left with is this group of patients who haven't already decided [whether] they're going to go to a mental health professional and they haven't already decided [whether] they're going to accept treatment. In many cases they don't even know that what they have is depression." Dr. Klinkman's theory is common among primary care physicians, but proof supporting it has been lacking -- until now. According to a paper in the December 2003 Journal of General Internal Medicine, depressed patients treated exclusively in the primary care setting are nearly three times more likely than those treated by mental health professionals to believe that no treatment modality is acceptable. Patients in this group also are more likely to believe that they will get over depression naturally, are less likely to accept antidepressants and are more likely to refuse counseling. "This is part of the reason that primary care doctors are so frustrated with treating depression," said Daniel E. Ford, MD, MPH, lead investigator and professor of medicine and psychiatry at Johns Hopkins University School of Medicine in Baltimore. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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