Views of patients diagnosed with depression and cared for by general practitioners and psychiatrists

OBJECTIVES: To explore the experiences of patients treated for depression either by general practitioners (GPs) or psychiatrists (Ps) with the aim of identifying improvement strategies. DESIGN: Health services research-oriented qualitative methodology. Exploratory design. PARTICIPANTS AND CONTEXTS: A total of 31 patients diagnosed with depression receiving pharmacological treatment for at least one year, belonging to 20 Health Centres and 8 Mental Health Centres of the Basque Health Service-Osakidetza in Bizkaia, and grouped according to the type of professional (GPs/Ps) and socioeconomic level. METHOD: Information generation by means of 5 discussion groups and 2 in-depth interviews carried out in 2009 and 2010. Recording and transcription with previous confidentiality agreement and informed consent. Sociological discourse analysis. Technique triangulation and agreement among researchers. RESULTS: Patients' experiences of depression are associated with their social contexts and their previous experience outside and inside the health services. These components also appear in perceptions on quality of care, with different expectations related to GPs and Ps. Deficiencies in time and psychotherapy are mentioned in general. Collaboration between both professionals does not spontaneously emerge as a patient priority. CONCLUSIONS: Patient assessments provide dimensions of individual and contextual components in the diagnosis and treatment of depression. These dimensions should be taken into account in the identification of needs and the design of strategies shared by GPs and Psychiatrists to improve care.