Depressive feelings as presented in primary care in the Netherlands

The article presents results of the study carried out in 2012—2013 and aimed at describing current primary care psychology in the Netherlands. Special attention was paid to diagnostics and treatment approaches to depression in primary care. Depression is currently ranked highly in the disease burden worldwide, and the problems of underdiagnostics of depression and the search for most effective treatment approaches are generally discussed. By means of literature analysis and interviews with practicing primary care psychologists we created a qualitative description of the process of recognition and approaching depressive complaints in primary care settings. The main findings on recognition of depression include described behavioral patterns that can become evident during a consultation with health care providers. These descriptions extend the accepted criteria for depression diagnostics to directions for observation during a consultation. Specific suggestions on treatment of depression expressed in interviews that compliment the steps of Multidisciplinary Guidelines for Depression in the Netherlands include addressing specific areas in a client's life, helping clients to restore relationships, activating the client, helping to express the feelings, and considering the etiology of current problems. The ultimate goals of counseling perceived by the primary care psychologists are generally oriented to increasing autonomy, freedom, and choice in clients. These concepts are likely to represent the important societal values currently in the Netherlands.