Conceptions of depressive disorder and its treatment among 17 Swedish GPs.A qualitative interview study

Background. Making clinical decisions for psychiatric patients in general p ractice is a complicated issue. A marked variation in the prescribing rates for antidepressant drugs in general as well as between geographical region s has been reported. Also, GPs tend to underestimate and undertreat depress ive disorders. Objectives. The aim of this study was to explore GPs' conceptions of depres sive disorder and its treatment. Method. A qualitative semi-structured interview was carried out on 17 GPs, selected to ensure variation of pre-conditions, in the county of Orebro, Sw eden. Informants' conceptions about four depression-related issues were det ermined: the depressive disorder, antidepressant drugs, the treatment decis ion and psychotherapy. Results. Conceptions of the four themes varied widely among informants in t he interviews. However, the informants shared certain conceptions concernin g the selection of drugs and drug treatment of major depression as well as the patient's role in deciding whether or not to treat pharmacologically. Conclusions. The study adds knowledge of GPs' thoughts about depressive dis order and their diagnostic and treatment preferences. Utilizing the concept s discussed herein, a quantitative study will be conducted to analyse how G Ps' conceptions of depression are inter-related.