Background
Methods
Recruitment
Patient questionnaire
Substudy to identify a case-finding algorithm
Definition of depressive symptomatology in the main study
GP telephone interview
Analysis of awareness rates and associated factors
GP judgement: depressive symptomatology (GP interview) | |||
---|---|---|---|
yes | no | ||
Depressive symptomatology according to algorithm (patient questionnaire) | yes | P(+/+) | P(+/−) |
no | P(−/+) | P(−/−) |
Ethics approval
Results
Sampling frame
Patients screened positive for depressive symptomatology | Patients screened negative for depressive symptomatology | |||||
---|---|---|---|---|---|---|
GP aware of depressive symptoms | GP not aware of depressive symptoms | Total | GP stated no depressive symptoms | GP stated depressive symptoms | Total | |
P (+/+) | P (+/−) | P (+) | P (−/−) | P (−/+) | P (−) | |
Total, N (%) | 201 (100%) | 373 (100%) | 574(100%) | 2229 (100%) | 421 (100%) | 2650 (100%) |
Age, mean (SD) | 71.9 (11.7) | 73.3 (11.4) | 72.8 (11.5) | 74.4 (9.9) | 73.4 (9.5) | 74.2 (9.9) |
Male gender, N (%) | 88 (43.8%) | 190 (50.9%) | 278 (48.4%) | 1272 (57.1%) | 178 (42.3%) | 1450 (54.7%) |
NYHA classification, N (%) | ||||||
Class I | 30 (14.9%) | 60 (16.1%) | 90 (15.7%) | 576 (25.8%) | 104 (24.7%) | 680 (25.7%) |
Class II | 80 (39.8%) | 180 (48.3%) | 260 (45.3%) | 1135 (50.9%) | 200 (47.5%) | 1335 (50.4%) |
Class III | 74(36.8%) | 110 (29.5%) | 184 (32.1%) | 440 (19.7%) | 97 (23.0%) | 537 (20.3%) |
Class IV | 12 (6.0%) | 20 (5.4%) | 32 (5.6%) | 38 (1.7%) | 15 (3.6%) | 53 (2.0%) |
GP judgement: depressive symptomatology (apparent depression or depressive symptoms), N (%) | 201 (100%) | 0 (0%) | 201 (35.0%) | 0 (0%) | 421 (100%) | 421 (15.9%) |
GP judgement: No depressive symptoms | 0 (0%) | 373 (100%) | 373 (65.0%) | 2229 (100%) | 0 (0%) | 2229 (84.1%) |
GP judgement: Depressive symptoms | 69 (34.3%) | 0 (0%) | 69 (12.0%) | 0 (0%) | 195 (46.3%) | 195 (7.4%) |
GP judgement: Apparent depression | 132 (65.7%) | 0 (0%) | 132 (23.0%) | 0 (0%) | 226 (53.7%) | 226 (8.5%) |
GP judgement: History of depression | 106 (52.7%) | 58 (15.5%) | 164 (28.6%) | 191 (8.6%) | 227 (53.9%) | 418 (15.8%) |
PHQ-9 Score, mean (SD) | 14.3 (4.4) | 13.0 (3.5) | 13.4 (3.9) | 4.0 (3.1) | 5.6 (3.4) | 4.3 (3.2) |
Taking any prescription antidepressant | 61 (30.3%) | 46 (12.3%) | 107 (18.6%) | 83 (3.7%) | 116 (27.6%) | 199 (7.5%) |
Rates of depressive symptomatology and GPs’ awareness of depressive symptomatology
Factors associated with GPs’ awareness of depressive symptomatology
Patient and GP characteristics | ||
---|---|---|
Variable |
p-value | Odds-Ratio [CI] |
Patient characteristics
| ||
Age | 0.970 | 1.000 [0.975; 1.024] |
Sex (male) | 0.430 | 1.226 [0.740; 2.031] |
Education (CASMIN) (Primary)
|
0.001
| |
Secondary
|
0.001
|
2.782 [1.542; 5.017]
|
Tertiary
|
0.021
|
3.599 [1.217; 10.642]
|
Employment (not employed) | 0.517 | 1.390 [0.513; 3.767] |
Health insurance (statutory) | 0.973 | |
Private | 0.944 | 0.955 [0.270; 3.376] |
Social security office | 0.823 | 0.714 [0.037; 13.824] |
Living situation (living alone) | 0.651 | |
together with others in private household | 0.788 | 1.082 [0.609; 1.924] |
living in an institution | 0.354 | 1.812 [0.516; 6.367] |
NYHA Class III-IV (reference Class I-II)
|
<0.001
|
2.518 [1.498; 4.231]
|
Comorbidity score | 0.379 | 0.958 [0.870; 1.054] |
PHQ-9
|
0.027
|
1.075 [1.008; 1.147]
|
History of Depression
|
<0.001
|
6.181 [3.562; 10.723]
|
Number of GP contacts (last 6 months)
|
0.028
|
1.036 [1.004; 1.070]
|
GP-consultations due to emotional distress within the last 6 months (no)
|
<0.001
|
3.185 [1.930; 5.256]
|
Familiarity of patient | 0.400 | 1.062 [0.923; 1.221] |
Perceived social support (ESSI) | 0.764 | 1.007 [0.964; 1.051] |
GP characteristics
| ||
Sex (male) | 0.826 | 1.067 [0.598; 1.905] |
Years of work experience | 0.937 | 0.999 [0.974; 1.025] |
Number of GPs practicing in the medical practice | 0.942 | 1.008 [0.805; 1.263] |
Additional qualification in psychology/psychiatry (no) | 0.442 | 0.787 [0.427; 1.450] |
Constant | 0.002 | 0.017 |