Theory and practice in the management of depressive disorders.
Scientific, professional, and governmental bodies have in recent years intensified efforts to formulate guidelines for the treatment of depression with the goal that medical practice should comply with these standards and thus improve patient care.'Evidence-based medicine'demands that medical practice should explicitly refer to the best available scientific knowledge.
Empirical data on the epidemiology of care suggest that there are major differences between guidelines and routine practice.
Failure to detect mental disorders range from 45 to 90%. Only 1 in 10 of those suffering from depression receive adequate treatment.
Treatment is insufficient as prescribed dosages are routinely too low, as up to 50% of treatments are ended prematurely and because patient non-compliance interferes with proper treatment application.
Psychological treatment is provided only in 60% of cases in need and is mostly unspecific, i.e. listening or giving advice.
Furthermore, there are large regional variations in prescribing patterns which show that treatment is influenced by many non-medical factors.
Empirical studies show that giving information to physicians or even measures to improve recognition alone are not sufficient to make changes in treatment behaviour.
Only if measures are taken to improve treatment interventions directly then, at least for more severe cases, could better illness outcome be shown. (...)
Mots-clés Pascal : Trouble psychiatrique, Soin, Allemagne, Europe, Recommandation, Gestion, Etat dépressif, Diagnostic, Traitement, Antidépresseur, Psychothérapie, Service santé, Efficacité traitement, Décision, Homme, Article synthèse, Essai clinique phase IV, Qualité service, Trouble humeur
Mots-clés Pascal anglais : Mental disorder, Care, Germany, Europe, Recommendation, Management, Depression, Diagnosis, Treatment, Antidepressant agent, Psychotherapy, Health service, Treatment efficiency, Decision, Human, Review, Phase IV trial, Service quality, Mood disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0376094
Code Inist : 002B30A01C. Création : 22/03/2000.