The Library
Diagnosis and management of depression in 3 countries : results from a clinical vignette factorial experiment
Tools
Tools
Tools
Link, Carol L., Stern, Theodore A., Piccolo, Rebecca S., Marceau, Lisa D., Arber, Sara, Adams, Ann, Siegrist, Johannes, von dem Knesebeck, Olaf and McKinlay, John B. (2011) Diagnosis and management of depression in 3 countries : results from a clinical vignette factorial experiment. Primary Care Companion to CNS Disorders, Vol.13 (No.5). doi:10.4088/PCC.11m01148 ISSN 2155-7780.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.4088/PCC.11m01148
Abstract
Objective: International differences in disease prevalence rates are often reported and thought to reflect different lifestyles, genetics, or cultural differences in care-seeking behavior. However, they may also be produced by differences among health care systems. We sought to investigate variation in the diagnosis and management of a "patient" with exactly the same symptoms indicative of depression in 3 different health care systems (Germany, the United Kingdom, and the United States).Method: A factorial experiment was conducted between 2001 and 2006 in which 384 randomly selected primary care physicians viewed a video vignette of a patient presenting with symptoms suggestive of depression. Under the supervision of experienced clinicians, professional actors were trained to realistically portray patients who presented with 7 symptoms of depression: sleep disturbance, decreased interest, guilt, diminished energy, impaired concentration, poor appetite, and psychomotor agitation or retardation.Results: Most physicians listed depression as one of their diagnoses (89.6%), but German physicians were more likely to diagnose depression in women, while British and American physicians were more likely to diagnose depression in men (P = .0251). American physicians were almost twice as likely to prescribe an antidepressant as British physicians (P = .0241). German physicians were significantly more likely to refer the patient to a mental health professional than British or American physicians (P < .0001). German physicians wanted to see the patient in follow-up sooner than British or American physicians (P < .0001).Conclusions: Primary care physicians in different countries diagnose the exact same symptoms of depression differently depending on the patient's gender. There are also significant differences between countries in the management of a patient with symptoms suggestive of depression. International differences in prevalence rates for depression, and perhaps other diseases, may in part result from differences among health care systems in different countries.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | R Medicine > R Medicine (General) | ||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||
| Journal or Publication Title: | Primary Care Companion to CNS Disorders | ||||
| Publisher: | Physicians Postgraduate Press, Inc. | ||||
| ISSN: | 2155-7780 | ||||
| Official Date: | 2011 | ||||
| Dates: |
|
||||
| Volume: | Vol.13 | ||||
| Number: | No.5 | ||||
| DOI: | 10.4088/PCC.11m01148 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
