Journal of General Internal Medicine

, Volume 23, Issue 10, pp 1567–1570

Contents of General Practitioner-Patient Consultations in the Treatment of Depression

  • Michael Linden
  • Tatjana Christof
  • Christiane Rentzsch
Original Article

DOI: 10.1007/s11606-008-0648-3

Cite this article as:
Linden, M., Christof, T. & Rentzsch, C. J GEN INTERN MED (2008) 23: 1567. doi:10.1007/s11606-008-0648-3

Abstract

BACKGROUND

Counseling of patients is an indispensable part of any drug treatment and even more so in the treatment of depression.

OBJECTIVE

To describe the content of counseling additional to prescribing an antidepressant drug.

SETTING

Sixty-three general practices from all over Germany.

PATIENTS

Three hundred two patients with the diagnosis of either a depressive episode or a recurrent depressive disorder.

MEASUREMENTS

Assessment of the content of the physician-patient encounter by content analysis following the pivotal topic method.

DESIGN

Qualitative study embedded in a drug utilization study on mirtazapine.

RESULTS

In the initial sessions general practitioners focused on building a good therapeutic alliance, assessing the symptoms of illness, explaining the course of treatment, assuring medication compliance, and discussing problems of life. In the middle phase of treatment, physicians also dealt with building a therapeutic alliance, medication compliance, and the progress and course of illness. In the last phase relapse prevention was an important topic. Psychological topics were more important than medication topics. Almost no importance was given to management of side effects, change of cognitions, or suicidal tendencies.

LIMITATIONS

No information is available on how content was actually discussed. Only encounters were observed where an antidepressant was prescribed.

CONCLUSIONS

Counseling plays an important part in day-to-day encounters of general practitioners. Pharmacotherapy is embedded in comprehensive psychological care. Training programs for general practitioners should be specific in respect to different tasks and parts of the physician-patient encounter (e.g., building a therapeutic alliance, support for life problems or change of cognitions).

KEY WORDS

depressionpivotal topic methodantidepressantcounseling

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Michael Linden
    • 1
  • Tatjana Christof
    • 1
  • Christiane Rentzsch
    • 1
  1. 1.Research Group Psychosomatic Rehabilitation at the Charité University Medicine BerlinTeltow/BerlinGermany