'I mean what is depression?' A qualitative exploration of UK general practitioners' perceptions of distinctions between emotional distress and depressive disorder
'I mean what is depression?' A qualitative exploration of UK general practitioners' perceptions of distinctions between emotional distress and depressive disorder
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DOI：
10.1136/bmjopen-2019-032644
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发表时间：
2019-12-01
期刊：
影响因子：
2.9
通讯作者：
Moore, Michael
中科院分区：
文献类型：
--
作者：
Geraghty, Adam W. A.;Santer, Miriam;Moore, Michael
目的抑郁症的检测是初级精神卫生保健的重要组成部分。然而，确定抑郁症是否存在于初级保健患者是复杂的。本定性研究的目的是探讨全科医生（GP）的看法之间的区别情绪困扰和抑郁disord.Design定性访谈study.Setting面对面和电话采访的GP从英格兰南部。参与者GP工作在英国初级保健的做法（n=21）。方法访谈遵循半结构化的采访指南，录音和转录。结果在直接考虑情绪困扰是否可以与抑郁障碍区分时，存在不同的观点。一些全科医生认为，由于症状是连续的，严重程度是疾病的代表，因此不可能进行区分。另一些代表团则侧重于区分的难度，并不确定。一些全科医生认为有区别，并提到情绪困扰更有可能在没有生物症状的压力源的存在。这也是常见的全科医生，指内源性和反应性抑郁症时，考虑可能的区别困扰和抑郁disorder.Conclusions全科医生的看法时，情绪症状反映障碍变化很大，提出了广泛的意见。需要进一步的研究来制定更一致的框架，以了解初级保健中的情绪症状。
Objective Detection of depression is a key part of primary mental healthcare. However, determining whether depressive disorder is or is not present in primary care patients is complex. The aim of this qualitative study was to explore general practitioners' (GPs) perceptions of distinctions between emotional distress and depressive disorder.Design Qualitative interview study.Setting Face to face and telephone interviews with GPs from the South of England.Participants GPs working in UK primary care practices (n=21).Method Interviews followed a semi-structured interview guide, were audio recorded and transcribed. Data were analysed thematically.Results Views were divergent when directly considering whether emotional distress could be distinguished from depressive disorder. Some GPs suggested a distinction was not possible as symptoms lay on a continuum, with severity as a proxy for disorder. Others focused on the difficulty of the distinction and were uncertain. Some GPs perceived a distinction and referred to emotional distress as more likely in the presence of a stressor with the absence of biological symptoms. It was also common for GPs to refer to endogenous and reactive depression when considering possible distinctions between distress and depressive disorder.Conclusions GPs' perceptions of when emotional symptoms reflect disorder varied greatly, with a broad range of views presented. Further research is needed to develop more consistent frameworks for understanding emotional symptoms in primary care.