Barriers in recognising, diagnosing and managing depressive and anxiety disorders as experienced by Family Physicians; a focus group study

BACKGROUND: The recognition and treatment of depressive- and anxiety disorders is not always in line with current standards. The results of programs to improve the quality of care, are not encouraging. Perhaps these programs do not match with the problems experienced in family practice. This study aims to systematically explore how FPs perceive recognition, diagnosis and management of depressive and anxiety disorders. METHODS: focus group discussions with FPs, qualitative analysis of transcriptions using thematic coding. RESULTS: The FPs considered recognising, diagnosing and managing depressive- and anxiety disorders as an important task. They expressed serious doubts about the validity and usefulness of the DSM IV concept of depressive and anxiety disorders in family practice especially because of the high frequency of swift natural recovery. An important barrier was that many patients have difficulties in accepting the diagnosis and treatment with antidepressant drugs. FPs lacked guidance in the assessment of patients' burden. The FPs experienced they had too little time for patient education and counseling. The under capacity of specialised mental health care and its minimal collaboration with FPs were experienced as problematic. Valuable suggestions for solving the problems encountered were made CONCLUSION: Next to serious doubts regarding the diagnostic concept of depressive- and anxiety disorders a number of factors were identified which serve as barriers for suitablemental health care by FPs. These doubts and barriers should be taken into account in future research and in the design of interventions to improve mental health care in family practice

Barriers in recognising, diagnosing and managing depressive and anxiety disorders as experienced by Family Physicians; a focus group study

BACKGROUND The recognition and treatment of depressive- and anxiety disorders is not always in line with current standards. The results of programs to improve the quality of care, are not encouraging. Perhaps these programs do not match with the problems experienced in family practice. This study aims to systematically explore how FPs perceive recognition, diagnosis and management of depressive and anxiety disorders. METHODS focus group discussions with FPs, qualitative analysis of transcriptions using thematic coding. RESULTS The FPs considered recognising, diagnosing and managing depressive- and anxiety disorders as an important task. They expressed serious doubts about the validity and usefulness of the DSM IV concept of depressive and anxiety disorders in family practice especially because of the high frequency of swift natural recovery. An important barrier was that many patients have difficulties in accepting the diagnosis and treatment with antidepressant drugs. FPs lacked guidance in the assessment of patients' burden. The FPs experienced they had too little time for patient education and counseling. The under capacity of specialised mental health care and its minimal collaboration with FPs were experienced as problematic. Valuable suggestions for solving the problems encountered were made CONCLUSION Next to serious doubts regarding the diagnostic concept of depressive- and anxiety disorders a number of factors were identified which serve as barriers for suitablemental health care by FPs. These doubts and barriers should be taken into account in future research and in the design of interventions to improve mental health care in family practice.This study was co-funded by the International Health Foundation, Utrecht, the Netherlands

The Beck Depression Inventory (BDI-II) and a single screening question as screening tools for depressive disorder in Dutch advanced cancer patients

Item does not contain fulltextPURPOSE: Depression is highly prevalent in advanced cancer patients, but the diagnosis of depressive disorder in patients with advanced cancer is difficult. Screening instruments could facilitate diagnosing depressive disorder in patients with advanced cancer. The aim of this study was to determine the validity of the Beck Depression Inventory (BDI-II) and a single screening question as screening tools for depressive disorder in advanced cancer patients. METHODS: Patients with advanced metastatic disease, visiting the outpatient palliative care department, were asked to fill out a self-questionnaire containing the Beck Depression Inventory (BDI-II) and a single screening question "Are you feeling depressed?" The mood section of the PRIME-MD was used as a gold standard. RESULTS: Sixty-one patients with advanced metastatic disease were eligible to be included in the study. Complete data were obtained from 46 patients. The area under the curve of the receiver operating characteristics analysis of the BDI-II was 0.82. The optimal cut-off point of the BDI-II was 16 with a sensitivity of 90% and a specificity of 69%. The single screening question showed a sensitivity of 50% and a specificity of 94%. CONCLUSIONS: The BDI-II seems an adequate screening tool for a depressive disorder in advanced cancer patients. The sensitivity of a single screening question is poor.1 februari 201

Farmacotherapie bij depressie

Dit is de tweede, geheel herziene druk van het Handboek depressieve stoornissen. Het geeft een up-to-date overzicht van zowel de wetenschappelijke als de behan­del­inhoudelijke kennis en ervaring rond deze veelvoorkomende, invaliderende en maatschappelijke relevante stoornis en sluit aan bij de DSM-5. Sinds de vorige druk uit 2008 is wereldwijd veel onderzoek verricht en werden vele nieuwe inzichten ten aanzien van ontstaan, preventie en behandeling van depressie ontwikkeld, die zijn meegenomen in het boek. Met oog voor de verschillende leeftijdsgroepen - jeugdigen, volwassenen en ouderen - worden de biologische, psychologische, sociale en culturele aspecten door een keur van ruim 60 Nederlandse en Vlaamse deskundigen in 32 hoofdstukken samengevat en besproken. Het boek is bedoeld voor de opleiding en bij- en nascholing van alle beroepsgroepen die met depressie te maken hebben, zoals verpleegkundigen, vaktherapeuten, huisartsen, bedrijfsartsen, psychologen, psychiaters, psychotherapeuten, verslavingsartsen, specialisten ouderengeneeskunde, maar zeker ook voor in depressie geïnteresseerde andere professionals, wetenschappers, patiënten en familie

Farmacotherapie bij depressie

Dit is de tweede, geheel herziene druk van het Handboek depressieve stoornissen. Het geeft een up-to-date overzicht van zowel de wetenschappelijke als de behan­del­inhoudelijke kennis en ervaring rond deze veelvoorkomende, invaliderende en maatschappelijke relevante stoornis en sluit aan bij de DSM-5. Sinds de vorige druk uit 2008 is wereldwijd veel onderzoek verricht en werden vele nieuwe inzichten ten aanzien van ontstaan, preventie en behandeling van depressie ontwikkeld, die zijn meegenomen in het boek. Met oog voor de verschillende leeftijdsgroepen - jeugdigen, volwassenen en ouderen - worden de biologische, psychologische, sociale en culturele aspecten door een keur van ruim 60 Nederlandse en Vlaamse deskundigen in 32 hoofdstukken samengevat en besproken. Het boek is bedoeld voor de opleiding en bij- en nascholing van alle beroepsgroepen die met depressie te maken hebben, zoals verpleegkundigen, vaktherapeuten, huisartsen, bedrijfsartsen, psychologen, psychiaters, psychotherapeuten, verslavingsartsen, specialisten ouderengeneeskunde, maar zeker ook voor in depressie geïnteresseerde andere professionals, wetenschappers, patiënten en familie

Measuring software energy efficiency: Presenting a methodology and case study on DNS resolvers

In this paper we present a methodology to measure the energy consumption of software. The methodology is based on detailed monitoring of power usage of hardware components. We explain our lab setup after which we apply the methodology to different pieces of DNS resolver software. Through this case study we demonstrate some of the uses of our methodology, as it can be used to determine which software performs the tasks at hand in the most energy efficient way, what the influence of software configuration can be, etcetera