General practitioners with a higher qualification in Family Medicine or General Practice: Are they better in diagnosing and treating patients with depression and anxiety?
Author(s)
Author(s)
Wong, S. Y. S.
Lee, K.
Chan, K.
Date Issued
2007
Publisher
The Hong Kong College of Family Physicians
Journal
The Hong Kong Practitioner
Volume
29
Issue
9
Start page
348
End page
356
Abstract
Objective: To compare the general practitioners with higher qualifications in Family Medicine or General Practice with those without in how they diagnose and treat patients presenting with depression and anxiety in primary care.
Design: 179 questionnaires were sent to all Family Medicine tutors affiliated with a university in Hong Kong. Subjects: 179 Family Medicine tutors affiliated with the Chinese University of Hong Kong; they were all involved in clinical teaching for undergraduate medical students. Main outcome measures: The main outcome measure is the odds of using various strategies of diagnosis and types of treatment for depression and anxiety among general practitioners with and without higher qualification in Family Medicine or General Practice. Results: 115 tutors replied; it gave a response rate of 64.2%. Those with higher qualifications were significantly more likely to diagnose depression and anxiety using the DSM or ICD criteria (72.3% vs. 42.0%, p<0.01 by chi-square test; adjusted odds ratio (OR) = 4.96; CI: 1.81 to 13.55, p<0.05 after adjustments were made for confounders). In terms of treatment, the general practitioners with higher qualifications were more likely to use psychological therapy (95.4% vs. 82.0%, p<0.05 by chi-square test; adjusted odds ratio (OR) = 3.98; CI: 0.79 to 19.9 and p=0.09) whereas those without higher qualifications were more likely to use "no treatment" (24.5% vs. 4.6%, p<0.01 by chi-square; adjusted odds ratio (OR) = 0.02; CI: 0.02 to 0.69, p<0.05). Conclusion: General practitioners with higher qualifications in Family Medicine or General Practice are different in how they diagnose and treat patients with depression and anxiety when compared with those without higher qualifications. 目的： 比較家庭醫生持有較高學歷與否對在診治抑鬱症和焦慮症患者時的異同。 設計： 以問卷郵寄往179位隸屬於本港一所大學的家庭醫學導師。 研究對象： 179位隸屬於香港中文大學的家庭醫學導師；他們全部都有參與醫科學生的臨床教學。 主要測量內容： 測量家庭醫生的持有較高學歷與否和其在診治抑鬱症和焦慮症時所採用的診斷方法和治療模式之間的關係。 結果： 115位導師回覆，回應率為64.2%。擁有較高學歷的家庭醫生明顯較常以診斷與統計手冊或國際疾病分類標準來診斷抑鬱症和焦慮症(72.3%對42%， 卡方檢定的p值<0.01，修正比對值=4.96，置信區間1.81至13.55，經修正混染因素後p值<0.05)。治療方面， 較高學歷的家庭醫生較常採用心理治療(95.4%對82.0%，卡方檢定的p值<0.05，修正比對值=3.98，置信區間0.79至19.9及p值=0.09)。 沒有較高學歷的家庭醫生較常不用任何治療(24.5%對4.6%，卡方檢定的p值<0.01，修正比對值=0.02，置信區間0.02至0.69，p值<0.05)。 結論： 有較高學歷的家庭醫生在診斷和治療抑鬱症和焦慮症患者方面，與沒有較高學歷的家庭醫生是有分別。
Design: 179 questionnaires were sent to all Family Medicine tutors affiliated with a university in Hong Kong. Subjects: 179 Family Medicine tutors affiliated with the Chinese University of Hong Kong; they were all involved in clinical teaching for undergraduate medical students. Main outcome measures: The main outcome measure is the odds of using various strategies of diagnosis and types of treatment for depression and anxiety among general practitioners with and without higher qualification in Family Medicine or General Practice. Results: 115 tutors replied; it gave a response rate of 64.2%. Those with higher qualifications were significantly more likely to diagnose depression and anxiety using the DSM or ICD criteria (72.3% vs. 42.0%, p<0.01 by chi-square test; adjusted odds ratio (OR) = 4.96; CI: 1.81 to 13.55, p<0.05 after adjustments were made for confounders). In terms of treatment, the general practitioners with higher qualifications were more likely to use psychological therapy (95.4% vs. 82.0%, p<0.05 by chi-square test; adjusted odds ratio (OR) = 3.98; CI: 0.79 to 19.9 and p=0.09) whereas those without higher qualifications were more likely to use "no treatment" (24.5% vs. 4.6%, p<0.01 by chi-square; adjusted odds ratio (OR) = 0.02; CI: 0.02 to 0.69, p<0.05). Conclusion: General practitioners with higher qualifications in Family Medicine or General Practice are different in how they diagnose and treat patients with depression and anxiety when compared with those without higher qualifications. 目的： 比較家庭醫生持有較高學歷與否對在診治抑鬱症和焦慮症患者時的異同。 設計： 以問卷郵寄往179位隸屬於本港一所大學的家庭醫學導師。 研究對象： 179位隸屬於香港中文大學的家庭醫學導師；他們全部都有參與醫科學生的臨床教學。 主要測量內容： 測量家庭醫生的持有較高學歷與否和其在診治抑鬱症和焦慮症時所採用的診斷方法和治療模式之間的關係。 結果： 115位導師回覆，回應率為64.2%。擁有較高學歷的家庭醫生明顯較常以診斷與統計手冊或國際疾病分類標準來診斷抑鬱症和焦慮症(72.3%對42%， 卡方檢定的p值<0.01，修正比對值=4.96，置信區間1.81至13.55，經修正混染因素後p值<0.05)。治療方面， 較高學歷的家庭醫生較常採用心理治療(95.4%對82.0%，卡方檢定的p值<0.05，修正比對值=3.98，置信區間0.79至19.9及p值=0.09)。 沒有較高學歷的家庭醫生較常不用任何治療(24.5%對4.6%，卡方檢定的p值<0.01，修正比對值=0.02，置信區間0.02至0.69，p值<0.05)。 結論： 有較高學歷的家庭醫生在診斷和治療抑鬱症和焦慮症患者方面，與沒有較高學歷的家庭醫生是有分別。
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