Physician-patient gender and the recognition and treatment of depression in primary care

This study investigates the relationships among patient's gender, physician 's gender, and physician's inquiries about depression symptoms and psychoso cial stressors, treatment and subsequent medical record notation of depress ion in primary care. One hundred forty-six physicians at three sites were v isited twice by a standardized patient (SP) who enacted either major depres sion with a psychosocial presentation or minor depression with a somatic pr esentation. Each of the two cases was portrayed by both male and female SPs who were assigned randomly to physicians. Results showed high rates of inq uiry about depression symptoms and treatment, but rates varied considerably by presentation and across physician-patient gender combinations. Male phy sicians explored symptoms and discussed a diagnosis with female patients si gnificantly more often than with male patients. Both male and female physic ians recommended counseling more often for patients with the somatic presen tation when they were female than when they were male. Record notations fol lowed the same gender pattern.