Abstract
BackgroundDepressive disorders are commonly managed in primary care and family physicians are ideally placed to serve as central providers to these patients. Around the world, the prevalence of depressive disorders in patients presenting to primary care is between 10-20%, of which around 50% remain undiagnosed. In Hong Kong, many barriers exist preventing the optimal treatment and management of patients with depressive disorders. The pathways of care, the long term outcomes and the factors affecting prognosis of these patients requires closer examination.Methods/DesignThe aim of this study is to examine the prevalence, incidence and natural history of depressive disorders in primary care and the factors influencing diagnosis, management and outcomes using a cross-sectional study followed by a longitudinal cohort study.Doctors working in primary care settings across Hong Kong have been invited to participate in this study. On one day each month over twelve months, patients in the doctor's waiting room are invited to complete a questionnaire containing items on socio-demography, co-morbidity, family history, previous doctor-diagnosed mental illness, recent mental and other health care utilization, symptoms of depression and health-related quality of life. Following the consultation, the doctors provide information regarding presenting problem, whether they think the patient has depression, and if so, whether the diagnosis is new or old, and the duration of the depressive illness if not a new diagnosis. If the doctor detects a depressive disorder, they are asked to provide information regarding patient management. Patients who consent are followed up by telephone at 2, 12, 26 and 52 weeks.DiscussionThe study will provide information regarding cross-sectional prevalence, 12 month incidence, remission rate, outcomes and factors affecting outcomes of patients with depressive disorders in primary care. The epidemiology, outcomes, pathways of care, predictors for prognosis and service needs for primary care patients with depressive disorders will be described and recommendations made for policy and service planning.
Highlights
Depressive disorders are commonly managed in primary care and family physicians are ideally placed to serve as central providers to these patients
The epidemiology, outcomes, pathways of care, predictors for prognosis and service needs for primary care patients with depressive disorders will be described and recommendations made for policy and service planning
The primary care setting is the point of entry for most people into the health system and primary care clinicians are ideally placed to serve as the central health care provider for patients with depressive disorders
Summary
Depressive disorders are commonly managed in primary care and family physicians are ideally placed to serve as central providers to these patients. In Hong Kong, many barriers exist preventing the optimal treatment and management of patients with depressive disorders. In Hong Kong, the 12-month general population prevalence of depressive disorders among adults aged 18-65 years has been estimated to be approximately 8.4% [2]. This is Around the world, the prevalence of depressive disorders in patients presenting to primary care has been estimated to be between 10-20%, of which around 50% remain undetected by doctors [6]. Many challenges exist in providing optimal care, including difficulties in recognizing patients with depression, developing an adequate diagnostic initial assessment, implementing treatment and management strategies, and integrating care of depression with that of co-existing chronic illnesses [7]
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