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

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Abstract
Background. Making clinical decisions for psychiatric patients in general practice is a complicated issue. A marked variation in the prescribing rates for antidepressant drugs in general as well as between geographical regions has been reported. Also, GPs tend to underestimate and undertreat depressive disorders. Objectives. The aim of this study was to explore GPs' conceptions of depressive 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 Örebro, Sweden. Informants' conceptions about four depression-related issues were determined: the depressive disorder, antidepressant drugs, the treatment decision and psychotherapy. Results. Conceptions of the four themes varied widely among informants in the interviews. However, the informants shared certain conceptions concerning 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 disorder and their diagnostic and treatment preferences. Utilizing the concepts discussed herein, a quantitative study will be conducted to analyse how GPs' conceptions of depression are inter-related.

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