Do family physicians and internists differ in knowledge, attitudes, and self-reported approaches for depression?

Area of Science:

• Primary Care Medicine
• Mental Health Research
• Medical Education

Background:

• Depression recognition and management are crucial components of primary care.
• Understanding physician self-assessment of skills and knowledge is key to improving mental health care delivery.
• Primary care physicians (PCPs) play a vital role in managing common mental health conditions.

Purpose of the Study:

• To evaluate the relationship between primary care specialty training and self-assessed competence in depression recognition and management.
• To compare internists and family physicians on their knowledge, attitudes, and behaviors regarding depression care.

Main Methods:

• A self-report questionnaire was administered to 184 internists and 138 family physicians.
• Participants were part of a multisite depression intervention study.
• Data collected included self-assessed skill, knowledge, attitudes, and behavior.

Main Results:

• No significant differences were found in knowledge or attitudes towards depression treatment between internists and family physicians.
• Family physicians reported higher self-assessed skill in managing depression compared to internists.
• Family physicians were more likely to prescribe SSRIs and counsel patients but less likely to refer to mental health specialists for moderate to severe depression.

Conclusions:

• Primary care physician orientation towards mental health issues must be considered in strategies to enhance mental health care.
• Despite higher self-rated skills, both specialties expressed uncertainty regarding psychotherapy and depression recurrence prevention.
• Tailored interventions may be needed to address specific gaps in primary care mental health management.