Psychiatric Quarterly

, Volume 89, Issue 2, pp 249–259 | Cite as

Knowledge and Attitudes Towards Clinical Depression among Community Medical Providers in Gujarat, India

  • Daniella A. LohEmail author
  • Amul Joshi
  • Kanako Taku
  • Nathaniel Mendelsohn
  • Craig L. Katz
Original Paper


There is limited data on how community medical providers in India attempt to diagnose and treat depression, as well as on their general knowledge of and attitudes toward depression. A cross-sectional survey was conducted assessing knowledge and views of clinical depression with 80 non-psychiatric physicians and physician trainees recruited from community clinics and hospitals in Gujarat, India. Interviews were also held with 29 of the physicians to assess what they do in their own practices in regards to detection of and treatment of clinical depression. Although subjects showed a generally good basic understanding of the definition of clinical depression and its treatment, their responses reflected the presence of some negative and/or stigmatized attitudes toward clinical depression. Our findings raise the question of possible stigma among physicians themselves and underscore the importance of combatting physicians’ stigma against and increasing awareness of how to detect and treat clinical depression.


Depression India Primary care Stigma Gujarat 



This study was funded by The Icahn School of Medicine at Mount Sinai.

Compliance with Ethical Standards

Conflict of Interest

Daniella A. Loh declares that she has no conflict of interest.

Amul Joshi declares that he has no conflict of interest.

Kanako Taku declares that she has no conflict of interest.

Nathaniel Mendelsohn declares that he has no conflict of interest.

Craig L. Katz declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013;10(11):e1001547. Scholar
  2. 2.
    World Health Organization. Depression Fact sheet N°369. 2017. Accessed 30 June2017.
  3. 3.
    CIA, The World Factbook- India. Accessed 30 June 2017.
  4. 4.
    Nieuwsma JA, Pepper CM, Maack DJ, Birgenheir DG. Indigenous perspectives on depression in rural regions of India and the United States. Transcult Psychiatry. 2011;48(5):539–68. Scholar
  5. 5.
    Pereira B, Andrew G, Pednekar S, Pai R, Pelto P, Patel V. The explanatory models of depression in low income countries: listening to women in India. J Affect Disord. 2007;102(1–3):209–18. Scholar
  6. 6.
    Andrew G, Cohen A, Salgaonkar S, Patel V. The explanatory models of depression and anxiety in primary care: a qualitative study from India. BMC Res Notes. 2012;5:499. Scholar
  7. 7.
    World Heath Organization and World Organization of Family Doctors (Wonca). Integrating mental health into primary care: a global perspective. 2008. Accessed 12 Jan 2016.
  8. 8.
    World Health Organization. Mental Health Atlas. Geneva. 2005. Accessed March 8, 2016.
  9. 9.
    Mitchell AJ, Vaze A, Rao S. Clinical diagnosis of depression in primary care: a meta-analysis. Lancet. 2009;374(9690):609–19. Scholar
  10. 10.
    Wittchen HU, Hofler M, Meister W. Prevalence and recognition of depressive syndromes in German primary care settings: poorly recognized and treated? Int Clin Psychopharmacol. 2001;16(3):121–35.CrossRefPubMedGoogle Scholar
  11. 11.
    Amin G, Shah S, Vankar GK. The prevelance and recognition of depression in primary care. Indian J Psychiatry. 1998;40(4):364–9.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Thirunavukarasu M, Thirunavukarasu P. Training and national deficit of psychiatrists in India - a critical analysis. Indian J Psychiatry. 2010;52(Suppl 1):S83–8. Scholar
  13. 13.
    Almanzar S, Shah N, Vithalani S, Shah S, Squires J, Appasani R, et al. Knowledge of and attitudes toward clinical depression among health providers in Gujarat. India Ann Glob Health. 2014;80(2):89–95. Scholar
  14. 14.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C.: American Psychiatric Assocation; 2013.CrossRefGoogle Scholar
  15. 15.
    Paykel ES, Priest RG. Recognition and management of depression in general practice: consensus statement. BMJ. 1992;305(6863):1198–202.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Srinivasan TN, Suresh TR. Non-specific symptoms and screening of non-psychotic morbidity in primary care. Indian J Psychiatry. 1990;32(1):77–82.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Patel V, Pereira J, Mann AH. Somatic and psychological models of common mental disorder in primary care in India. Psychol Med. 1998;28(1):135–43.CrossRefPubMedGoogle Scholar
  18. 18.
    Pradeep J, Isaacs A, Shanbag D, Selvan S, Srinivasan K. Enhanced care by community health workers in improving treatment adherence to antidepressant medication in rural women with major depression. Indian J Med Res. 2014;139(2):236–45.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Chadda RK, Shome S. Psychiatric aspects of clinical practice in general hospitals: a survey of non-psychiatric clinicians. Indian J Psychiatry. 1996;38:86–91.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Chaudhary RK, Mishra BP. Knowledge and practices of general practitioners regarding psychiatric problems. Ind Psychiatry J. 2009;18(1):22–6. Scholar
  21. 21.
    Challapallisri V, Dempster LV. Attitude of doctors towards mentally ill in Hyderabad, India: results of a prospective survey. Indian J Psychiatry. 2015;57(2):190–5. Scholar
  22. 22.
    Aydin N, Yigit A, Inandi T, Kirpinar I. Attitudes of hospital staff toward mentally ill patients in a teaching hospital. Turkey Int J Soc Psychiatry. 2003;49(1):17–26.CrossRefPubMedGoogle Scholar
  23. 23.
    Stefanovics E, He H, Ofori-Atta A, Cavalcanti MT, Neto HR, Makanjuola V, et al. Cross-National Analysis of beliefs and attitude toward mental illness among medical professionals from five countries. Psychiatry Q. 2016;87(1):63–73. Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Daniella A. Loh
    • 1
    Email author
  • Amul Joshi
    • 2
  • Kanako Taku
    • 3
  • Nathaniel Mendelsohn
    • 4
  • Craig L. Katz
    • 1
    • 5
  1. 1.Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.MINDS Foundation, E102 Kuber Residency, Opp Nilamber BungalowsVadodaraIndia
  3. 3.Department of PsychologyOakland UniversityRochesterUSA
  4. 4.U.S. Department of Veterans Affairs Palo Alto Healthcare SystemPalo AltoUSA
  5. 5.Department of Medical EducationIcahn School of Medicine at Mount SinaiNew YorkUSA

Personalised recommendations