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Depression Research: Symptom Disclosure in Primary Care

Could you describe the aim of the study?

We conducted interviews with women with depression to learn about the things that make it easier or harder to talk with primary care providers about their depression symptoms.

Could you describe the women included in the study?

We interviewed adult African American, Hispanic, and non-Hispanic White women who had been diagnosed with depression or were experiencing symptoms of depression at the time of the study. To be included in the study, women needed to have seen a healthcare provider at least one time within the 12 months before the study.

What would you say are the key take-home messages from this study?

First, women may be reluctant to talk to primary care provider about depression because they feel that these providers are more concerned with physical health. Second, positive patient-provider relationships are critical for encouraging discussion about depression symptoms in primary care. Third, women are more likely to share information about symptoms of depression if they feel that doing so will help them get the care they need. Lastly, women felt that the limited amount of time that they have with providers makes it harder to talk about depression.

How would these findings impact clinical practice?

The study findings suggest that women are reluctant to talk about depressive symptoms with primary care providers, but that they are more open to discussing how they feel if providers ask directly about depression and show sincere concern for their responses. In order to encourage more women to talk about depression, it is important that providers follow the U.S. Preventive Services Task Force recommendations and routinely screen women for depression. Providers must also be able to demonstrate that they understand the feelings women are describing when they are sharing information about depressive symptoms.The study findings also highlight the importance of including women with depression in the treatment decision-making process. Women may be more likely to talk about depression if doing so will benefit them, but this may be tempered by the fear that they will be forced to accept a specific treatment. Including women as active participants in the treatment decision-making process not only encourages conversations about depression but may also improve the likelihood of a woman accepting treatment. While it may be extremely challenging to increase the amount of time women with depression can spend with a single provider, using a team approach to providing care may help these women. By being able to have interactions with other health care team members, women will have more opportunities to establish a relationship with a clinician and more health care contacts. Ultimately, this might give women more chances to talk about symptoms of depression.

The study findings also highlight the importance of including women with depression in the treatment decision-making process. Women may be more likely to talk about depression if doing so will benefit them, but this may be tempered by the fear that they will be forced to accept a specific treatment. Including women as active participants in the treatment decision-making process not only encourages conversations about depression but may also improve the likelihood of a woman accepting treatment. While it may be extremely challenging to increase the amount of time women with depression can spend with a single provider, using a team approach to providing care may help these women. By being able to have interactions with other health care team members, women will have more opportunities to establish a relationship with a clinician and more health care contacts. Ultimately, this might give women more chances to talk about symptoms of depression.

What future studies would you recommend to further examine this topic?

We did not interview women who had not seen a provider in the year before the study or women who did not speak English; therefore, our findings may not capture the experiences of these women. These populations should be a focus of future research given that women with depression who do not seek care and those who do not speak English may be at greater risk for negative outcomes.

Link to the Primary Paper:

Keller AO, Valdez CR, Schwei RJ, and Jacobs EA. Disclosure of Depression Symptoms in Primary Care: A Qualitative Study of Women’s Perceptions. Women’s  Health Issues. 2016;26(5):529-36. doi: 10.1016/j.whi.2016.07.002.


Abiola Keller

Dr. Abiola Keller

Abiola Keller, PA-C, MPH, PhD is the Director of Clinical Research and a clinical assistant professor of Physician Assistant Studies in the College of Health Sciences at Marquette University. Dr. Keller’s research efforts focus on individual, provider, and health system factors, and their impact on social disparities in mental healthcare. Visit Dr. Keller’s Linkedin page: www.linkedin.com/in/abiola-keller-021a1038

 

About Abiola Keller, PA-C, MPH, PhD and Professor at Marquette University

Alternative Text

Abiola Keller, PA-C, MPH, PhD is the Director of Clinical Research and a clinical assistant professor of Physician Assistant Studies in the College of Health Sciences at Marquette University. Dr. Keller’s research efforts focus on individual, provider, and health system factors, and their impact on social disparities in mental healthcare.

Abiola Keller on the Web
More on: Depression
Latest update: November 26, 2016