Hutten, W. (Wendelien) (2013) General Practitioner characteristics and the risk of a chronic – or recurring depression in General Practice. thesis, Medicine.
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Abstract
Background: Depression is a common illness that is associated with a lot of morbidity. Most depressive patients are treated in primary care, under supervision of the General Practitioner (GP). The course of depression can be favorable (the depression goes into remission) or unfavorable (the patient experiences recurrent or chronic depression). A lot of research has been done on clinical and patient characteristics that influence the course of a depressive disorder in secondary care and some in general practice, but not yet on if and which GP characteristics influence the course of a depressive disorder in patients. Objective: To find out which GP characteristics are risk factors for an unfavorable course of depression. Methods: We used data of primary care respondents from the Netherlands Study of Depression and Anxiety with a current (in the past six months) depressive disorder. GPs of the recruited patients filled in a questionnaire. Dependent variable in our statistical analysis was the course of depression on T2 and T4 (favorable or unfavorable). Independent variables were GP characteristics. We corrected for clinical variables known to influence the course. All variables that were significant with p<0,05 in the bivariate multilevel analysis were put into the multivariate multilevel regression model to find relevant GP characteristics that influence the course of depression. Results: 63,8% of depressed patients had an unfavorable course on T2. On T4 this had grown to 72,6%. On T2 patients more often have a favorable course when their GP feels that he/she has a positive influence on other people once a week or more and patients more often have an unfavorable course when a GP experiences an inadequate joint treatment with the primary care psychologist. On T4 patients more often have a favorable course when their GP has a special interest in depression and when their GP thinks that psychiatric problems do not cost too much time to treat in a daily GP practice. Conclusion: This study shows that several GP characteristics are risk factors for an unfavorable course of depression. It is important that GPs acknowledge that their characteristics can influence the course of depression and anticipate to this by for instance implementing a collaborative care model in their practice. Furthermore our results differ after two years and after four years; this should be studied further in future research.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Verhaak, dr. P.F.M. and Brand-Piek, dr. E. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2293 |
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