Abstract
BackgroundGeneral practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). However, little is known about the ways in which they proceed. The aim of this study is to analyze GPs’ management and patterns of referral to other health professionals of patients with work-related CMD and associated factors.MethodWe used data from a cross-sectional study of 2027 working patients of 121 GPs in the Nord – Pas-de-Calais region in France (April – August 2014). Statistical analyses focused on patients with work-related CMD detected by the GP and examined the ways in which GPs managed these patients’ symptoms. Associations between patient, work, GP and contextual characteristics and GPs’ management were explored using modified Poisson regression models with robust variance.ResultsAmong the 533 patients with work-related CMD in the study, GPs provided psychosocial support to 88.0%, prescribed psychotropic treatment to 82.4% and put 50.7% on sick leave. Referral rates to mental health specialists and occupational physicians were respectively 39.8 and 26.1%. Several factors including patients’ characteristics (occupational and sociodemographic), GPs’ characteristics and environmental data were associated with the type of management used by the GP.ConclusionOur study emphasizes the major and often lonesome role of the GP in the management of patients with work-related CMDs. Better knowledge of the way GPs manage those patients could help GPs in their practice, improve patients care and be a starting point to implement a more collaborative care approach.
Highlights
General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse)
Several factors including patients’ characteristics, GPs’ characteristics and environmental data were associated with the type of management used by the GP
Our results indicate that GPs follow trends that have been highlighted among workers
Summary
General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). The position of the GP varies considerably across countries and health care systems, as well as depending on patients’ expectations and GPs’ task performance In some countries such as the Netherlands, Spain and the UK, the GP is a gatekeeper to specialists and the treatment of patients with psycho-social problems is primarily GPs’ task. In others countries such as France, Belgium, Germany and Switzerland, patients can access a specialist directly and visiting the GP is optional [7, 11,12,13,14,15]. In France, visiting a GP is a frequent option because of availability and health insurance coverage, which in most cases is at best partial for mental health specialists
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