Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY 10032, USA.
Acta Psychiatr Scand. 2012 Nov;126(5):385-92. doi: 10.1111/j.1600-0447.2012.01887.x. Epub 2012 May 23.
To measure how primary care physicians (PCPs) and psychiatrists treat mild depression.
We surveyed a national sample of US PCPs and psychiatrists using a vignette of a 52-year-old man with depressive symptoms not meeting Major Depressive Episode criteria. Physicians were asked how likely they were to recommend an antidepressant counseling, combined medication, and counseling or to make a psychiatric referral.
Response rate was 896/1427 PCPs and 312/487 for psychiatrists. Compared with PCPs, psychiatrists were more likely to recommend an antidepressant (70% vs. 56%), counseling (86% vs. 54%), or the combination of medication and counseling (61% vs. 30%). More psychiatrists (44%) than PCPs (15%) were 'very likely' to promote psychiatric referral. PCPs who frequently attended religious services were less likely (than infrequent attenders) to refer the patient to a psychiatrist (12% vs. 18%); and more likely to recommend increased involvement in meaningful relationships/activities (50% vs. 41%) and religious community (33% vs. 17%).
Psychiatrists treat mild depression more aggressively than PCPs. Both are inclined to use antidepressants for patients with mild depression.
衡量初级保健医生（PCP）和精神科医生如何治疗轻度抑郁症。
我们使用一位 52 岁男性的案例研究对美国的 PCP 和精神科医生进行了全国性调查，该案例研究的患者有抑郁症状但不符合重度抑郁发作标准。医生被问及他们推荐抗抑郁药咨询、联合药物治疗和咨询或进行精神科转介的可能性有多大。
PCP 的回复率为 896/1427，精神科医生的回复率为 312/487。与 PCP 相比，精神科医生更有可能推荐抗抑郁药（70%比 56%）、咨询（86%比 54%）或药物和咨询的联合治疗（61%比 30%）。更多的精神科医生（44%）比 PCP（15%）更有可能推荐进行精神科转介。经常参加宗教服务的 PCP 比不经常参加宗教服务的 PCP 更不可能（12%比 18%）将患者转介给精神科医生；更有可能推荐增加参与有意义的关系/活动（50%比 41%）和宗教社区（33%比 17%）。
精神科医生比 PCP 更积极地治疗轻度抑郁症。两者都倾向于为轻度抑郁症患者开抗抑郁药。
