Institute of Psychiatry, University of Bologna, Viale C, Pepoli 5, IT-40123 Bologna, Italy.
BMC Fam Pract. 2013 Jun 7;14:75. doi: 10.1186/1471-2296-14-75.
Evidences from literature suggest that Primary Care Physicians' (PCPs) knowledge and attitude about psychological and pharmacological treatments of anxiety and depressive disorders could influence their clinical practice. The aim of the study is double: 1) to assess PCPs' opinions about antidepressants (ADs) and psychotherapy for the management of anxiety and depressive disorders; 2) to evaluate the influence of PCPs' gender, age, duration of clinical practice, and office location on their opinions and attitudes.
This cross-sectional multicentre survey involved 816 PCPs working in four Local Health Units of the Emilia Romagna Region. Participating PCPs were asked to complete a questionnaire during educational meetings between October 2006 and December 2008.
The response rate was 65.1%. Eighty-five percent of PCPs agreed on the effectiveness of ADs for depressive disorder whereas lower agreement emerged for anxiety disorder and on psychotherapy for both anxiety and depression. Forty percent of PCPs reported to feel "very/extremely confident" in recognizing depression and 20.0% felt equally confident in treating it with pharmacotherapy. Considering anxiety disorder, these proportions increased. Female PCPs and those located in the rural/mountain areas reported to adopt more psycho-educational support compared to male and suburban colleagues.
Our results suggest that an effort should be made to better disseminate recent evidences about the management of anxiety and depressive disorders in Primary Care. In particular, the importance of psychological interventions and the role of drugs for anxiety disorder should be addressed.
文献中的证据表明，初级保健医生（PCP）对焦虑和抑郁障碍的心理和药物治疗的知识和态度可能会影响他们的临床实践。本研究的目的有两个：1）评估 PCP 对管理焦虑和抑郁障碍的抗抑郁药（ADs）和心理治疗的看法；2）评估 PCP 的性别、年龄、临床实践年限和办公地点对其意见和态度的影响。
这是一项横断面多中心调查，涉及艾米利亚-罗马涅地区四个地方卫生单位的 816 名 PCP。参与的 PCP 被要求在 2006 年 10 月至 2008 年 12 月期间的教育会议期间填写问卷。
应答率为 65.1%。85%的 PCP 同意 ADs 对抑郁障碍的有效性，而对焦虑障碍和心理治疗对焦虑和抑郁的有效性则持较低的共识。40%的 PCP 报告说在识别抑郁症方面感到“非常/极其自信”，20.0%的 PCP 对用药物治疗它感到同样自信。考虑到焦虑障碍，这些比例增加了。与男性和郊区同事相比，女性 PCP 和位于农村/山区的 PCP 报告说采用了更多的心理教育支持。
我们的结果表明，应该努力更好地传播关于初级保健中焦虑和抑郁障碍管理的最新证据。特别是，应该强调心理干预的重要性和药物在焦虑障碍中的作用。
