ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2012
What we talk about when we talk about depression: doctor-patient conversations and treatment decision outcomes.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators to GP-patient communication about emotional concerns in UK primary care: a systematic review.Family practice · 2020Pooled it
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- The Role of Health Care Communication in Treatment Outcomes.Annual review of linguistics · 2023Article
- Performance Assessment of Certain Machine Learning Models for Predicting the Major Depressive Disorder among IT Professionals during Pandemic times.Computational intelligence and neuroscience · 2021Article
- Matter over mind: How mental health symptom presentations shape diagnostic outcomes.Health (London, England : 1997) · 2020Article
- A survey of UK general practitioners about depression, antidepressants and withdrawal: implementing the 2019 Public Health England report.Therapeutic advances in psychopharmacology · 2020Article
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- Sensor-Assisted Weighted Average Ensemble Model for Detecting Major Depressive Disorder.Sensors (Basel, Switzerland) · 2019Article
- Severe Depressive Episode with Psychotic Symptoms and Type 2 Diabetes: A 2010-2017 Longitudinal Study.Medical science monitor : international medical journal of experimental and clinical research · 2019Article
- From mental disorder to shared understanding: a non-categorical approach to support individuals with distress in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Guidance by physicians and pharmacists during antidepressant therapy: patients' needs and suggestions for improvement.BMC psychiatry · 2017Article
- Latvian family physicians' experience diagnosing depression in somatically presenting depression patients: A qualitative study.The European journal of general practice · 2017Article
- How do healthcare professionals interview patients to assess suicide risk?BMC psychiatry · 2017Article
- 'She believed in me'. What patients with depression value in their relationship with practitioners. A secondary analysis of multiple qualitative data sets.Health expectations : an international journal of public participation in health care and health policy · 2017Article
- Therapeutic consultations for patients with depressive symptoms.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Why underserved patients do not consult their general practitioner for depression: results of a qualitative and a quantitative survey at a free outpatient clinic in Paris, France.BMC family practice · 2015Observational
- Primary care professional's perspectives on treatment decision making for depression with African Americans and Latinos in primary care practice.Journal of immigrant and minority health · 2014Article
- Revisiting the J shaped curve, exploring the association between cardiovascular risk factors and concurrent depressive symptoms in patients with cardiometabolic disease: Findings from a large cross-sectional study.BMC cardiovascular disorders · 2014Article
- Depression diagnosis and treatment amongst multimorbid patients: a thematic analysis.BMC family practice · 2014Article
- Article
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9 authors.
Funding
Abstract
backgroundEfforts to address depression in primary care settings have focused on the introduction of care guidelines emphasising pharmacological treatment. To date, physician adherence remains low. Little is known of the types of information exchange or other negotiations in doctor-patient consultations about depression that influence physician decision making about treatment.
aimThe study sought to understand conversational influences on physician decision making about treatment for depression.
designA secondary analysis of consultation data collected in other studies. Using a maximum variation sampling strategy, 30 transcripts of primary care consultations about distress or depression were selected from datasets collected in three countries. Transcripts were analysed to discover factors associated with prescription of medication.
methodThe study employed two qualitative analysis strategies: a micro-analysis approach, which examines how conversation partners shape the dialogue towards pragmatic goals; and a narrative analysis approach of the problem presentation.
resultsPatients communicated their conceptual representations of distress at the outset of each consultation. Concepts of depression were communicated through the narrative form of the problem presentation. Three types of narratives were identified: those emphasising symptoms, those emphasising life situations, and mixed narratives. Physician decision making regarding medication treatment was strongly associated with the form of the patient's narrative. Physicians made few efforts to persuade patients to accept biomedical attributions or treatments.
conclusionResults of the study provide insight into why adherence to depression guidelines remains low. Data indicate that patient agendas drive the 'action' in consultations about depression. Physicians appear to be guided by common-sense decision-making algorithms emphasising patients' views and preferences.
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