Section of Primary Care Mental Health, Health Service and Population Research Department, Institute of Psychiatry at King's College London, London SE5 8AF, UK.
Fam Pract. 2012 Apr;29(2):121-30. doi: 10.1093/fampra/cmr070. Epub 2011 Sep 15.
Depression in primary care is common but under-recognized and suboptimally managed. Health professionals' attitudes are likely to play an important part in their recognition and management of depression.
To pool findings from studies using the Depression Attitude Questionnaire (DAQ) to provide greater detail of clinicians' attitudes and the measure's psychometric properties.
Electronic databases and grey literature were searched for relevant studies. Data from eligible studies were requested and pooled analysis conducted.
Twenty studies were eligible and data were obtained from 12 of these involving GPs (n = 1543) and nurses (n = 984). Responses showed strong disagreement that depression is due to ageing or weakness. European GPs were more positive about depression treatments than UK GPs; nurses were more favourable about psychotherapy than GPs. UK GPs especially strongly opposed notions that depression is best managed by psychiatrists. Trends over time indicated increasing acknowledgement of psychological therapies and the nurse's role in depression management. Factor analysis indicated that many DAQ items fitted weakly within an overall model. The most parsimonious solution involved two factors: a positive view of depression and its treatment response and professional confidence in depression management.
Individual DAQ items appear to measure key aspects of clinicians' attitudes to depression, and item responses indicate important differences between professions and geographical settings as well as changes over time. There are problems with the DAQ as a scale: its internal consistency is weak, and several items appear specific to particular professions or service structures, indicating that this questionnaire should be revised.
初级保健中的抑郁症很常见，但未得到充分认识，且管理不善。医疗保健专业人员的态度可能在他们识别和管理抑郁症方面起着重要作用。
汇总使用抑郁态度问卷（DAQ）的研究结果，更详细地了解临床医生的态度和该测量工具的心理测量特性。
电子数据库和灰色文献检索相关研究。要求符合条件的研究提供数据，并进行汇总分析。
有 20 项研究符合条件，其中 12 项研究（涉及全科医生 n = 1543 和护士 n = 984）提供了数据。研究结果显示，参与者强烈不同意抑郁是由衰老或虚弱引起的。与英国全科医生相比，欧洲全科医生对抑郁治疗的看法更为积极；护士比全科医生更赞成心理治疗。英国全科医生尤其强烈反对抑郁最好由精神科医生管理的观念。随着时间的推移，出现了对心理治疗和护士在抑郁管理中的作用越来越多的认识。因子分析表明，DAQ 的许多项目在整体模型中拟合程度较弱。最简约的解决方案涉及两个因素：对抑郁及其治疗反应的积极看法，以及对抑郁管理的专业信心。
DAQ 中的各个项目似乎都能衡量临床医生对抑郁症态度的关键方面，项目的反应表明了不同专业和地理位置之间的重要差异，以及随着时间的推移发生的变化。DAQ 作为一个量表存在问题：其内部一致性较弱，并且有几个项目似乎特定于特定的专业或服务结构，表明该问卷需要修订。
