Titre de l`article

Titre de l'article
Psychotherapy for depression in primary care: a panel survey of general practitioners'
opinion and prescribing practice.
Auteur(s)
Hélène Verdoux (1) (2) (7)
Sébastien Cortaredona (3) (4) (5)
Hélène Dumesnil (3) (4) (5)
Remy Sebbah (6)
Pierre Verger (3) (4) (5)
Affiliation(s) du ou des auteurs
1. University Bordeaux, U657, 33000, Bordeaux, France
2. INSERM, U657, 33000, Bordeaux, France
3. INSERM, UMR-S912 (SESSTIM), 13006, Marseille, France
4. Aix Marseille Université, UMR-S912, IRD, 13006, Marseille, France
5. ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d’Azur, 13006,
Marseille, France
6. Union Régionale des Professionnels de Santé, Médecins Libéraux, PACA, 13006,
Marseille, France
7. Centre Hospitalier Charles Perrens, 121 rue de la Béchade, 33076, Bordeaux Cedex,
France
Résumé
PURPOSE:
Psychotherapy is recommended as first-line treatment in patients presenting with mild-tomoderate depression. Although this disorder is mostly managed in primary care, little is
known about General Practitioners' (GPs) practice of prescribing psychotherapy. The
objectives were to explore GPs' opinion on psychotherapy for depression, and the personal
and professional characteristics associated with reported strategies for prescribing
psychological therapy and/or an antidepressant in mild-to-moderate depression.
METHODS:
A cross-sectional survey was carried out among participants in a panel of randomly selected
GPs (2,114/2,496 participated: 84.7 %). GPs were interviewed using a standardized
questionnaire covering their professional and personal characteristics, their practices and
opinions in the area of depression management. A multi-model averaging approach was
used to explore the characteristics associated with practice of prescribing psychological
therapy in mild-to-moderate depression.
RESULTS:
Most GPs had a favourable opinion regarding the efficacy of psychotherapy in depression.
Slightly more than one out of four reported prescribing psychological therapy alone often/very
often in mild-to-moderate depression. These GPs were more likely to be female (OR = 1.56,
95 % CI 1.24; 1.97), to have a personal history of psychotherapy (OR = 1.76, 95 % CI 1.31;
2.38), no history of depression in someone close (OR = 0.80, 95 % CI 0.65; 0.99), and to
consider that antidepressants are over-prescribed (OR = 2.02, 95 % CI 1.63; 2.49). No
association was found with professional characteristics.
CONCLUSIONS:
GPs' personal experience has a greater impact on psychological therapy prescription than
professional characteristics. This finding suggests that educational efforts are required for
providing GPs decision-making skills regarding psychological therapy prescription, based
upon evidence-based medicine rather than subjective factors.
Mots-clés
Depression, Primary care, Psychotherapy, Antidepressant
Revue
Social Psychiatry and Psychiatric Epidemiology
Source
Soc Psychiatry Psychiatr Epidemiol. 2013 Jun 16.
Editeur
Springer-Verlag
Lien
http://link.springer.com/article/10.1007%2Fs00127-013-0717-8