Depression Nondisclosure to Primary Care Doctor Common

Major reason for nondisclosure is patient's concern that physician will recommend antidepressants

TUESDAY, Sept. 13 (HealthDay News) -- Many adults do not disclose depression to their primary care physicians because of their beliefs, with concern about the physician recommending antidepressants being the most frequent reason for nondisclosure, according to a study published in the September/October issue of the Annals of Family Medicine.

Robert A. Bell, Ph.D., from the University of California in Davis, and colleagues investigated people's reasons for not disclosing depression to their primary care physicians. A follow-up telephonic survey was conducted for 1,054 adult participants from the California Behavioral Risk Factor Survey System. Participants were asked about the reasons for nondisclosure of depressive symptoms to their primary care physician, beliefs related to depression, and demographic characteristics. The perceived barriers to depression disclosure were characterized by descriptive and inferential statistical procedures.

The investigators found that 43 percent of respondents gave one or more reasons for nondisclosure of depression. The most frequent reason for nondisclosure was a concern that the physician would recommend antidepressants. History of depression formed the basis for variation in the reasons reported for nondisclosure. Individuals with no history of depression were more likely to believe that depression was outside the realm of primary care, and feared being referred to a psychiatrist. Individuals with clinically significant symptoms of depression rated 10 of 11 barriers to disclosure as more personally applicable than those without depressive symptoms. Demographic characteristics, depression beliefs, symptom severity, and absence of a family history of depression predicted the number of reported disclosure barriers.

"Many adults subscribe to beliefs likely to inhibit explicit requests for help from their primary care physician during a depressive episode," the authors write.

Two of the study authors disclosed financial ties to the pharmaceutical industry.

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