• Shen-Ing Liu, Ru-Band Lu, and Ming-Been Lee.
• Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan. liuyip@ms23.hinet.net
• J Formos Med Assoc. 2008 Dec 1; 107 (12): 921-31.

Background/PurposeDepression is a major health concern, often treated by non-psychiatrists. This study assessed self-reported knowledge, attitudes and treatment practices of non-psychiatric physicians in the recognition and management of depression.MethodsSurvey questionnaires were given to non-psychiatric physicians who attended a depression training program. We asked physicians about their current clinical practice, knowledge, confidence, attitudes and perceived barriers to care regarding recognition and management of patients with depression.ResultsOf 524 eligible non-psychiatric physicians, 375 (72%) completed surveys. The majority of physicians held a strong sense of responsibility for managing depression, although they provided treatment to only a small proportion of depressed patients. Most of them were not confident treating depressed patients, and they reported that incomplete knowledge and training were major barriers that limited their involvement. The patient and organization barriers were not related to reported management, but the physician barriers (lack of skills and knowledge in managing depression) were related to reported rate of treatment. Age, prior depression training, and education were major contributing factors to domains of knowledge, attitude and behavior, in terms of the number of domains involved. Family physician orientation was associated with higher score on knowledge scale, but not with other variables of attitude and behavior.ConclusionOur study suggests that non-psychiatrists may also play a role in the care of depression, but identifying and managing depression can be a challenge to them. Attitudinal barriers, confidence, and knowledge of treatment may compromise the physicians ability to manage depression. Future interventions and educational efforts need to address each of these issues.

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