Latvian family physicians’ experience diagnosing depression in somatically presenting depression patients : A qualitative study

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dc.contributor.authorLeff, Maija S.
dc.contributor.authorVrubļevska, Jeļena
dc.contributor.authorLūse, Agita
dc.contributor.authorRancāns, Elmārs
dc.contributor.institutionDepartment of Psychiatry and Narcology
dc.contributor.institutionKomunikācijas studiju katedra
dc.date.accessioned2021-04-22T12:40:02Z
dc.date.available2021-04-22T12:40:02Z
dc.date.issued2017-10-02
dc.descriptionFunding Information: This project was funded by a Fulbright Program grant sponsored by the Bureau of Educational and Cultural Affairs of the United States Department of State and administered by the Institute of International Education. Publisher Copyright: © 2017 The Author(s).
dc.description.abstractBackground: Depression continues to be under-diagnosed in primary care settings. One factor that influences physicians’ likelihood of diagnosing depression is patients’ presentation style. Patients who initially present with somatic symptoms are diagnosed at a lower rate and with greater delay than patients who present with psychosocial complaints. Objectives: To identify the barriers preventing depression diagnosis in somatically presenting patients in an Eastern European primary care setting. Methods: Thematic analysis of semi-structured interviews with 16 family physicians (FPs) in Latvia. FPs were sampled using a maximum variation strategy, varying on patient load, urban/ rural setting, FP gender, presence/absence of on-site mental health specialists, and FP years of practice. Results: FPs observed that a large subgroup of depression patients presented with solely somatic complaints. FPs often did not recognize depression in somatically presenting patients until several consultations had passed without resolution of the somatic complaint. When FPs had psychosocial information about the somatically presenting patient, they recognized depression more quickly. Use of depression screening questionnaires was rare. Barriers to diagnosis continued beyond recognition. Faced with equivocal symptoms that undermined clinical certainty, FPs postponed investigating their clinical suspicion that the patient had depression and pursued physical examinations that delayed depression diagnosis. FPs also used negative physical examination results to convince reluctant patients of a depression diagnosis. Conclusion: Delayed recognition, the need to rule out physical illness, and the use of negative physical examination results to discuss depression with patients all slowed the path to depression diagnosis for somatically presenting patients in Latvian primary care.en
dc.description.statusPeer reviewed
dc.format.extent7
dc.format.extent1136449
dc.identifier.citationLeff, M S, Vrubļevska, J, Lūse, A & Rancāns, E 2017, 'Latvian family physicians’ experience diagnosing depression in somatically presenting depression patients : A qualitative study', European Journal of General Practice, vol. 23, no. 1, pp. 91-97. https://doi.org/10.1080/13814788.2017.1291626
dc.identifier.doi10.1080/13814788.2017.1291626
dc.identifier.issn1381-4788
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/3904
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85030421276&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofEuropean Journal of General Practice
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectDepression
dc.subjectDiagnosis
dc.subjectGeneral practice
dc.subjectQualitative methods
dc.subjectUnexplained somatic complaints
dc.subject3.2 Clinical medicine
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectFamily Practice
dc.subjectSDG 3 - Good Health and Well-being
dc.titleLatvian family physicians’ experience diagnosing depression in somatically presenting depression patients : A qualitative studyen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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