Biersack Katharina, Sattel Heribert, Schönweger Petra, Kaspar Lea, Lehnen Nadine, Gensichen Jochen, Henningsen Peter
Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Technical University of Munich, Munich, Germany.
Faculty of Medicine, Chair of Public Health and Health Service Research, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), LMU Munich, Munich, Germany.
PLoS One. 2025 Jun 5;20(6):e0293713. doi: 10.1371/journal.pone.0293713. eCollection 2025.
Depressive disorders are common in the primary care setting. Despite its high prevalence, depression treatment in primary care is less guideline-oriented compared to specialized settings, which often makes it less efficient. Current research has focused on explanations on the practitioner's side but has neglected the patient's perspective and its effect on treatment largely.
We conducted a scoping review on the electronic databases Medline and Psycinfo. Eligible publications contained information of the patients' perspective on depression treatment in primary care in OECD member states. Publications until August 2nd 2023 were considered.
After the removal of duplicates, the search yielded 14.059 articles, of which 232 were included. Current literature focuses on behavioral and obvious measures like satisfaction, and on patient-sided barriers and facilitators to adherence. Other treatment-related behaviors are less researched. Patients with undiagnosed depression often report exclusively or mainly physical symptoms in general practice.
This review provides a comprehensive framework for the concept. Research on barriers and facilitators to depression treatment in primary care is still inconclusive. Educating patients and addressing stigmatizing beliefs are promising targets to promote the seeking out, initiation of, and adherence to treatment. Being aware of a hidden depression when somatic symptoms are present, can help to detect more cases.
This review is registered via OSF (https://osf.io/p9rnc).
抑郁症在基层医疗环境中很常见。尽管其患病率很高，但与专科环境相比，基层医疗中的抑郁症治疗较少遵循指南，这往往使其效率较低。目前的研究主要集中在从业者方面的解释，而很大程度上忽略了患者的观点及其对治疗的影响。
我们对电子数据库Medline和Psycinfo进行了范围综述。符合条件的出版物包含经合组织成员国患者对基层医疗中抑郁症治疗的观点信息。纳入截至2023年8月2日的出版物。
去除重复项后，检索到14059篇文章，其中232篇被纳入。当前文献关注行为和明显的指标，如满意度，以及患者方面的依从性障碍和促进因素。其他与治疗相关的行为研究较少。在全科医疗中，未被诊断出患有抑郁症的患者通常只报告或主要报告身体症状。
本综述为该概念提供了一个全面的框架。关于基层医疗中抑郁症治疗的障碍和促进因素的研究仍无定论。对患者进行教育并消除污名化观念是促进寻求、开始和坚持治疗的有希望的目标。当出现躯体症状时意识到潜在的抑郁症，有助于发现更多病例。
本综述通过OSF（https://osf.io/p9rnc）注册。
