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  Vol. 2 No. 10, October 1993 TABLE OF CONTENTS
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The Role of Primary Care Clinician Attitudes, Beliefs, and Training in the Diagnosis and Treatment of Depression

A Report From the Ambulatory Sentinel Practice Network Inc

Deborah S. Main, PhD; Lawrence J. Lutz, MD, MSPH; James E. Barrett, MD; John Matthew, MD; Rebecca S. Miller, MS

Arch Fam Med. 1993;2(10):1061-1066.


Abstract

Objective
To examine the relation between primary care clinicians' attitudes, beliefs, and training and their perceptions of the importance and frequency of depression.

Design
A 56-item questionnaire was mailed to 226 clinicians in the Ambulatory Sentinel Practice Network Inc (ASPN), a primary care research network.

Setting
The ASPN, consisting of 69 primary care practices in the United States and Canada, cares for approximately 350 000 patients.

Main Outcome Measure
The degree to which clinician training in depression and clinician attitudes and beliefs about treating depression predict their perceptions of the importance of depression in their primary care practices.

Results
Results of path analysis indicate that clinician training in depression, beliefs about the burden and discomfort associated with diagnosing and treating depression, perceptions of their patients' discomfort, and self-efficacy in diagnosing and treating depression are all significantly related to clinician perceptions of whether depression was an important and frequent primary care problem. Further analysis indicates that actual prevalence of depression accounted for little variability in clinicians' beliefs and attitudes about depression.

Conclusions
What clinicians think their patients feel about issues on depression and how they view their own abilities may profoundly influence the degree to which they recognize depression in primary care. Understanding these factors may help explain and subsequently decrease clinician variability in the recognition of depression in primary care.



Author Affiliations

From the Department of Family Medicine, University of Colorado Health Sciences Center (Drs Main and Lutz and Ms Miller), and the Ambulatory Sentinel Practice Network Inc (Ms Miller), Denver; the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (Dr Barrett); and The Health Center, Plainfield, Vt (Dr Matthew).



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