Perceptions about anxiety, depression and somatization in general medical settings: A qualitative study.
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Date
2012-11
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Abstract
Background. The recognition rates of anxiety and
depression in general medical settings, despite the significant
prevalence of such presentations, are low. Psychiatrists argue
that the recognition and management of these conditions by
physicians is less than optimal in primary care and general
practice. We did this study to gain insights into physicians’
perspectives on anxiety, depression and somatization, the
conceptual models they employ and the practical problems
they face in managing such patients in general medical settings.
Methods. Focus group discussions (FGDs) were conducted
with family and primary care physicians. The FGDs for physicians
were tape recorded and transcribed, verbatim. The views of
psychiatrists working in liaison clinics were also ascertained.
Results. Family and primary physicians admitted to a high
prevalence of patients who present with medically unexplained
symptoms. They noted the co-occurrence of psychosocial
stress. All physicians working in general medical settings
admitted to difficulty in separating anxiety, depression and
somatic presentations because of milder, less distinct syndromes
and overlapping symptoms. They argued that it was difficult
to use the current three-category division and that a more
complex classification would be time-consuming and impractical
in primary care.
Conclusion. Psychiatric classifications for use in primary
care should consider the different context and employ
physicians’ perspectives rather than push specialist concepts
and criteria.
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KURUVILLA A, JACOB K S. Perceptions about anxiety, depression and somatization in general medical settings: A qualitative study. National Medical Journal of India. 2012 Nov-Dec ; 25(6): 332-335.