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Community Mental Health Journal

, Volume 55, Issue 1, pp 137–143 | Cite as

The Management of Depressed Patients by the Tunisian General Practitioners: A Critical Trans-sectional Study

  • Jihène Ben ThabetEmail author
  • Manel Mâalej
  • Hana Khemakhem
  • Sourour Yaich
  • Wafa Abbes
  • Sana Omri
  • Lobna Zouari
  • Nasreddine Zouari
  • Jamel Dammak
  • Nada Charfi
  • Mohamed Maâlej
Original Paper
  • 41 Downloads

Abstract

Under-diagnosed and under-treated, depression has a pejorative prognosis. The general practitioners (GP) represent the most often consulted healthcare professionals by depressed patients. The aim was to describe how the Tunisian GPs manage the depressed patients and to note the difficulties they encounter in order to suggest corrective measures. A survey was conducted among 140 GPs in Sfax Governorate. The percentage of the GPs whose responses conformed to the scientific data in at least 67% of the items was 31.4%. Four factors were correlated to a good management of depression: age (p = 0.028), masculine gender (p = 0.016), long career (p = 0.034) and participation to continuous medical education sessions on depression (p = 0.01). Our study revealed inadequacies in the management of depression by the GPs. GPs were invited to sensitizing meetings. A training on depression was assured for the future internship supervisors by the commission of medicine of family in the Faculty of Medicine of Sfax.

Keywords

Critical study Depression General practitioners Management 

Notes

Acknowledgements

We wish to thank all the general practitioners who accepted to participate to this study. We also wish to thank Dr Sharaf Amir, a native English speaker and an international medical manger, for the proofreading.

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflicts of interest concerning this article.

Ethical Approval

This manuscript complies to the Ethical Rules applicable for Community Mental Health Journal.

References

  1. Agence française de sécurité sanitaire des produits de santé [AFSSAPS]. (2006). Bon usage des médicaments antidépresseurs dans le traitement des troubles dépressifs et des troubles anxieux de l’adulte. Recommandations.Google Scholar
  2. Agence nationale d’accréditation et d’évaluation en santé [ANAES]. (2002). Prise en charge d’un épisode dépressif isolé de l’adulte en ambulatoire. Recommandations.Google Scholar
  3. Amara, G., Ayachi, M., Ben Nasr, S., & Ben Hadj Ali, B. (2010). Perception par les médecins du rôle du généraliste dans la prise en charge des troubles mentaux: Importance, difficultés et perspectives. La Tunisie Médicale, 88(1), 33–37.Google Scholar
  4. Amourda, M. V. (2012). Place du généraliste dans la prise en charge du 1e épisode dépressif. Évaluations des connaissances des praticiens installés en Île-de-France. Saarbrücken: Editions universitaires européennes.Google Scholar
  5. Anderson, I. M. (2000). Selective serotonin reuptake inhibitors versus tricyclic antidepressants: A meta-analysis of efficacy and tolerability. Journal of Affective Disorders, 58(1), 19–36.CrossRefGoogle Scholar
  6. Berhili, N. (2010). La dépression: connaissances et attitudes des médecins généralistes.Google Scholar
  7. Boyer, P., Dardennes, R., Even, C., Gaillac, V., Gerard, A., Lecrubier, Y., et al. (1999). Dépression et santé publique: Données et réflexions. Paris: AcantheGoogle Scholar
  8. Briffault, X., Morvan, Y., Rouillon, F., Dardennes, R., & Lamboy, B. (2008). Recours aux soins et adéquation des traitements de l’épisode dépressif majeur en France. Encéphale.  https://doi.org/10.1016/j.encep.2008.10.01.Google Scholar
  9. Douki, S., Nacef, F., & Ben Zineb, S. (2005). La psychiatrie en Tunisie: une discipline en devenir. L’Information Psychiatrique, 81, 49–59.Google Scholar
  10. Fischer, S., Miccinesi, G., Hornung, R., Bosshard, G., Deliens, L., van der Heide, A., et al. (2006). Responders and non-responders in a study on medical end-of-life decisions in Denmark, the Netherlands, Sweden and Switzerland. SozPraventivmed, 51, 24–33.Google Scholar
  11. Frémont, P., Gérard, A., Sechter, D., Vanelle, J. M., & Vidal, M. (2008). L’alliance thérapeutique au début d’une prise en charge pour dépression par le généraliste. Encéphale.  https://doi.org/10.1016/j.encep.2008.03.001.Google Scholar
  12. Hadoun, K., Ansseau, M., Bertrand, J., & Lejeune, J. (2007). Influence de l’âge du médecin généraliste sur la prise en charge de la dépression. Acta Psychiatrica Belgica, 107, 55–65.Google Scholar
  13. Hérique, A., & Kahn, J. P. (2007). Réalités et recommandations dans la prescription et l’observance des antidépresseurs en médecine générale: évaluation des pratiques dans le traitement de la dépression en Lorraine et Champagne-Ardenne. Encéphale.  https://doi.org/10.1016/j.encep.2007.12.010.Google Scholar
  14. Johnston, O., Kumar, S., Kendall, K., Peveler, R., Gabbay, J., & Kendrick, T. (2007). Qualitative study of depression management in primary care: GP and patient goals, and the value of listening. British Journal of General Practice, 57, e1–e14.CrossRefGoogle Scholar
  15. Kellerman, S., & Herold, J. (2001). Physician response to surveys a review of the literature. American Journal of Preventive Medicine, 20(1), 61–67.CrossRefGoogle Scholar
  16. Kühne, F., Behmann, M., Bisson, S., Walter, U., & Schneider, N. (2011). Non-response in a survey of physicians on end-of-life care for the elderly. BMC Research Notes, 4, 367.CrossRefGoogle Scholar
  17. Lamboy, B. (2006). Prise en charge des personnes souffrant de troubles dépressifs – Données d’enquête en population générale. doi: ENC-10-2006-32-5-0013-7006-101019-200630113.Google Scholar
  18. Liu, S. I., Lu, R. B., & Lee, M. B. (2008). Non-psychiatric physicians’ knowledge, attitudes and behavior toward depression. Journal of the Formosan Medical Association, 107(12), 921–931.CrossRefGoogle Scholar
  19. Magalon-Bingenheimer, K., Magalon, D., Zendjidjian, X., Boyer, L., Griguer, Y., & Lançon, C. (2012). Dépression en médecine générale. Presse Medicale.  https://doi.org/10.1016/j.lpm.2012.09.008.Google Scholar
  20. Martinez, L. (2002). Recommandations pour traiter la dépression: avantages et limites de la normalisation. La Revue du Praticien - Médecine générale, 16, 587.Google Scholar
  21. Mathers, C. D., & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3(11), 442.CrossRefGoogle Scholar
  22. McManus, P., Mant, A., Mitchell, P., Britt, H., & Dudley, J. (2003). Use of antidepressants by general practitioners and psychiatrists in Australia. Australian and New Zealand Journal of Psychiatry, 37(2), 184–189.CrossRefGoogle Scholar
  23. Mercier, A., Kerhuela, N., Stalnikiewitz, B., Aulanierc, S., Boulnoisd, C., & Becreta, F. (2009). Enquête sur la prise en charge des patients dépressifs en soins primaires: les médecins généralistes ont des difficultés et des solutions. Encéphale.  https://doi.org/10.1016/j.encep.2009.04.002.Google Scholar
  24. Murray, C. J. L., & Lopez, A. D. (1997). The global burden of disease. Cambridge: Published by the Harvard School of Public Health on Behalf of the World Health Organization and the World Bank distributed by Harvard University Press.Google Scholar
  25. Organisation mondiale de la santé. (2001). Rapport sur la santé dans le monde 2001.La santé mentale: nouvelle conception, nouveaux espoirs. Genève: OMS.Google Scholar
  26. Porst, R. (2001). Wie man die Rücklaufquote bei postalischen Befragungenerhöht. ZUMA How-to-Reihe (Vol. 9). Mannheim: Zentrum für Umfragen, Methoden und AnalysenGoogle Scholar
  27. Ransdell, L. B. (1996). Maximizing response rate in questionnaire research. American Journal of Health Behavior, 20, 50–56.Google Scholar
  28. Saeed, M., & McCall, L. (2006). General Practitioners knowledge and attitude towards anxiety and depression in Abu Dhabi. Middle East Journal of Family Medicine, 4(1), 148.Google Scholar
  29. Sagduyu, A., Özmen, E., Aker, T., Ögel, K., Uguz, F., & Tamar, D. (2008). Knowledge and attitudes of general practitioners about depression new. Yeni Symposium Journal Ekim, 46(4), 206–214.Google Scholar
  30. Seale, C. (2009). Legislation of euthanasia or physician-assisted suicide: Survey of doctors’ attitudes. Palliative Medicine, 23, 205–212.CrossRefGoogle Scholar
  31. Taleb, M., Rouillon, F., Hegerl, U., Hamdani N., & Gorwood, Ph. (2006). Les programmes d’action contre la dépression. ENC, doi: ENC-2-2006-32-1-0013-7006-101019-200630001.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jihène Ben Thabet
    • 1
    • 3
    Email author return OK on get
  • Manel Mâalej
    • 1
  • Hana Khemakhem
    • 1
  • Sourour Yaich
    • 2
  • Wafa Abbes
    • 1
  • Sana Omri
    • 1
  • Lobna Zouari
    • 1
  • Nasreddine Zouari
    • 1
  • Jamel Dammak
    • 2
  • Nada Charfi
    • 1
  • Mohamed Maâlej
    • 1
  1. 1.Psychiatry C Department, Faculty of Medicine of SfaxUniversity Hospital Hedi ChakerSfaxTunisia
  2. 2.Department of Preventive Medicine, Faculty of Medicine of SfaxUniversity Hospital Hedi ChakerSfaxTunisia
  3. 3.Faculty of Medicine of Sfax, University of SfaxSfaxTunisia

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