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BMC Psychiatry
Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Research article

Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study

Authors: Tsuyuka Ohtsuki, Masatoshi Inagaki, Yuetsu Oikawa, Akiyoshi Saitoh, Mie Kurosawa, Kumiko Muramatsu, Mitsuhiko Yamada

Published in: BMC Psychiatry | Issue 1/2010

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Abstract

Background

A general internist has an important role in primary care, especially for the elderly in rural areas of Japan. Although effective intervention models for depressed patients in general practice and primary care settings have been developed in the US and UK medical systems, there is little information regarding even the recognition rate and prescription rate of psychotropic medication by general internists in Japan. The present study surveyed these data cross-sectionally in a general internal medicine outpatient clinic of a Japanese rural hospital.

Methods

Patients were consecutively recruited and evaluated for major depressive disorder or any mood disorder using the Patient Health Questionnaire (PHQ). Physicians who were blinded to the results of the PHQ were asked to diagnose whether the patients had any mental disorders, and if so, whether they had mood disorders or not. Data regarding prescription of psychotropic medicines were collected from medical records.

Results

Among 312 patients, 27 (8.7%) and 52 (16.7%) were identified with major depressive disorder and any mood disorder using the PHQ, respectively. Among those with major depressive disorder, 21 (77.8%) were recognized by physicians as having a mental disorder, but only three (11.1%) were diagnosed as having a mood disorder.
Only two patients with major depressive disorder (7.4%) had been prescribed antidepressants. Even among those (n = 15) whom physicians diagnosed with a mood disorder irrespective of the PHQ results, only four (26.7%) were prescribed an antidepressant.

Conclusions

Despite a high prevalence of depression, physicians did not often recognize depression in patients. In addition, most patients who were diagnosed by physicians as having a mood disorder were not prescribed antidepressants. Multiple barriers to providing appropriate care for depressed patients exist, such as recognizing depression, prescribing appropriate medications, and appropriately referring patients to mental health specialists.
Appendix
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Metadata
Title
Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study
Authors
Tsuyuka Ohtsuki
Masatoshi Inagaki
Yuetsu Oikawa
Akiyoshi Saitoh
Mie Kurosawa
Kumiko Muramatsu
Mitsuhiko Yamada
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-30

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