Key result
The frequency of antidepressant prescription by general practitioners was 8.90%, with 18% of prescriptions for non-psychiatric conditions, strongly influenced by multi-morbidity and contextual problems.
Cross-Sectional (n=3,522)
Yes
General practitioners frequently prescribe antidepressants for complex contextual situations and multi-morbid patients, utilizing a biopsychosocial approach rather than a purely biological one.
Answers are grounded in this paper and cite their sources.
GP antidepressant use often targets multi-morbidity and context; leaves open whether this biopsychosocial pattern improves outcomes or warrants scrutiny.
BACKGROUND: The frequency of antidepressant (ADs) prescription is high, with general practitioners (GPs) responsible for about 80% of the prescriptions. Some studies considered prescriptions meet DSM criteria, while others stress inadequate use. The importance of biological and psychosocial determinants of GP prescription behaviour remains little explored. We aimed to describe the importance of these biological and psychosocial determinants and their weight in the daily practice of GPs'. METHODS: During a week chosen at random, 28 GPs collected the AD prescriptions made within the previous six months, regardless of the reason for the patient contact. Bio psychosocial and AD treatment characteristics were recorded for all patients. In a random sample of 50 patients, patient characteristics were assessed via a structured face-to-face interview with the GP. RESULTS: The frequency of AD prescription was 8.90% [3.94 -17.02]. The GPs initiated 65.6% [60.1-70.8] of the prescriptions. The rate of AD prescription for non-psychiatric conditions was 18%. Patients had from 1 to 9 conditions, showing a high level of multi-morbidity. There was a strong influence of past medical history and contextual problems, such as work related problems. CONCLUSION: AD prescription is related to complex contextual situations and multi-morbid patients. GPs use a bio psycho social approach, rather than a purely biological assessment. Awareness of these influences could improve prescription by GPs.
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Mercier et al. (2014) conducted a cross-sectional in Antidepressant prescription (n=3,522). Antidepressant prescription was evaluated on Frequency of antidepressant prescription (95% CI 3.94-17.02). The frequency of antidepressant prescription by general practitioners was 8.90%, with 18% of prescriptions for non-psychiatric conditions, strongly influenced by multi-morbidity and contextual problems.
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