OBJECTIVE: To discover primary care physicians' attitudes toward their
abilities to detect and treat depression in the elderly. DESIGN: A se
lf-administered questionnaire sent to 1,000 primary care physicians in
the state of Michigan. SETTING: The survey was sent to physicians who
practice general internal medicine or family medicine. PARTICIPANTS:
The questionnaire was sent to 500 MD and 500 DO physicians: equal repr
esentation was given to general internal medicine and family medicine,
Of all 1,000 physicians, 60% (n = 604) responded, 51% (n = 309) were
MD's, 48% (n = 295) were DO's, 41% (n = 245) were general internists,
and 59% (n = 359) were family medicine physicians. MEASUREMENTS AND MA
IN RESULTS: Despite positive attitudes about their skills for detectin
g and treating depression in the elderly, only one quarter of the resp
ondents routinely used a screening tool in practice, Forty-one percent
of all physicians were not aware of depression practice guidelines, F
amily physicians were more confident about their treatment skills than
were general internists (85% vs 50%; chi(2) = 11.42, p less than or e
qual to .003). Male physicians more often endorsed pharmacologic treat
ment, while female physicians more frequently used counseling and exer
cise techniques to treat depressed older patients, Half of all physici
ans felt knowledgeable about community resources to treat older depres
sed patients. CONCLUSIONS: This survey identified several perceived ne
eds for future targeted interventions: (1) additional Agency for Healt
h Care Policy and Research guideline exposure for all primary care phy
sicians, (2) targeted counseling skip intervention for male physicians
and medication management for female physicians, and (3) additional c
ontinuing medical education intervention for practicing general intern
ists, Further research is needed to correlate physician attitudes with
ensuing behaviors to fully appreciate the nature of late-life depress
ion treatment within the primary care arena.