Ohtsuki Tsuyuka, Kodaka Manami, Sakai Rumi, Ishikura Fuminobu, Watanabe Yoichiro, Mann Anthony, Haddad Mark, Yamada Mitsuhiko, Inagaki Masatoshi
Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
BMC Res Notes. 2012 Aug 16;5:441. doi: 10.1186/1756-0500-5-441.
Under-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors' attitude toward depression.
The inclusion criteria of participants in the present study were as follows: 1) Japanese non-psychiatric doctors and 2) attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1) a workshop to depression care for non-psychiatric doctors and 2) a general physician-psychiatrist (G-P) network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ), a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis.
We received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187) disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112) agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101) agreed. Meanwhile, 67 % of doctors (n = 126) thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly different to that of British GPs.
Japanese non-psychiatric doctors believe that depression care is beyond the scope of their duties. It is suggested that educational programs or guidelines for depression care developed in other countries such as the UK are not directly adaptable for Japanese non-psychiatric doctors. Developing a focused educational program that motivates non-psychiatric doctors to play a role in depression care is necessary to enhance recognition and treatment of depression in Japan.
在许多国家，抑郁症未被充分认识的情况很常见。对医务人员进行教育，重点关注他们对抑郁症的态度，可能有必要改变他们的行为并提高对抑郁症的认识。此前已有多项研究报道了全科医生对抑郁症的态度。然而，对于日本非精神科医生的态度却知之甚少。在本研究中，我们调查了非精神科医生对抑郁症的态度。
本研究参与者的纳入标准如下：1）日本非精神科医生；2）参加过抑郁症护理相关教育活动的人员。我们方便地接触了两类人群：1）面向非精神科医生的抑郁症护理工作坊；2）全科医生 - 精神科医生（G - P）网络小组。我们联系了367名受试者。使用抑郁症态度问卷（DAQ）来测量对抑郁症的态度，这是一份为全科医生编制的包含20个条目的自填式问卷。我们报告每个DAQ条目的得分以及探索性因素分析得出的因素。
我们收到了230名受试者的回复，并使用了187名符合纳入标准的非精神科医生的DAQ数据。所有非精神科医生（n = 187）都不同意“我在处理抑郁症患者的需求时感到自在”，而60%（n = 112）同意“与抑郁症患者共事很艰难”。因素分析表明这些条目构成了一个名为“抑郁症应由精神科医生治疗”的因素，54%的医生（n = 101）同意这一点。同时，67%的医生（n = 126）认为护士在支持抑郁症患者方面可能会有所帮助。源自日本DAQ的三个因素与先前源自英国全科医生样本的模型不同。日本非精神科医生对于抑郁症是否应由精神科医生治疗的态度与英国全科医生明显不同。
日本非精神科医生认为抑郁症护理超出了他们的职责范围。这表明在其他国家（如英国）制定的抑郁症护理教育项目或指南并不直接适用于日本非精神科医生。制定一个有针对性的教育项目，激励非精神科医生在抑郁症护理中发挥作用，对于提高日本对抑郁症的认识和治疗水平是必要的。
