Treatment and follow-up of anxiety and depression in clinical-scenario patients: Survey of Saskatchewan family physicians

Article Figures & Data

Table 1

Physicians’ suggested treatment plans for GAD and MDE clinical-scenario patients

TREATMENT PLAN	GAD CLINICAL SCENARIO (N = 160), N (%)	MDE CLINICAL SCENARIO (N = 171), N (%)
Immediate^*
• Pharmacotherapy alone	42 (26.3)	22 (12.9)
• Counseling^† alone	6 (3.8)	12 (7.0)
• Pharmacotherapy and counseling	40 (25.0)	27 (15.8)
• Pharmacotherapy or counseling plus other^‡	14 (8.8)	18 (10.5)
• Other alone	3 (1.9)	16 (9.4)
• Total immediate	105 (65.6)	95 (55.6)
Delayed
• Pharmacotherapy alone	12 (7.5)	7 (4.1)
• Counseling^† alone	3 (1.9)	1 (0.6)
• Pharmacotherapy and counseling	3 (1.9)	6 (3.5)
• Pharmacotherapy or counseling plus other^‡	2 (1.3)	3 (1.8)
• Other alone	0	1 (0.5)
• Await results before deciding	25 (15.6)	41 (24.0)
• Total delayed	45 (28.1)	59 (34.5)
No treatment	3 (1.9)	2 (7.0)
No response	7 (4.4)	5 (2.9)

GAD—generalized anxiety disorder, MDE—major depressive episode.
↵* Statements considered indicative of “immediate” treatment included those that did not refer to delaying treatment, delaying a decision regarding treatment, or awaiting laboratory results.
↵† Included counseling by a family physician and referral for counseling.
↵‡ Treatment or action other than pharmacotherapy and counseling, such as breathing techniques, reassurance, education, and recommendations of more sun, dietary changes, exercise, diary writing, books to read, meditation, sleep, rest, stress reduction, and sick leave.

Table 2

Physicians’ suggested length of time to the first follow-up visit for GAD and MDE clinical-scenario patients

TIME ELAPSED UNTIL FIRST FOLLOW-UP	GAD CLINICAL SCENARIO (N = 160), N (%)	MDE CLINICAL SCENARIO (N = 171), N (%)
1 wk or sooner	55 (34.4)	59 (34.5)
1–2 wk	72 (45.0)	82 (48.0)
3–4 wk	8 (5.0)	7 (4.1)
More than 4 wk	10 (6.3)	11 (6.4)
No response	15 (9.4)	12 (7.0)

Table 3

Physicians’ perceived barriers to providing optimal care to GAD and MDE clinical-scenario patients

BARRIERS TO CARE	GAD CLINICAL SCENARIO (N = 160), N (%)	MDE CLINICAL SCENARIO (N = 171), N (%)
Any barrier mentioned^*	107 (66.9)	111 (64.9)
Physician-related barriers
• Too busy	28 (17.5)	27 (15.8)
• Requires specialist referral or consultation	12 (7.5)	11 (6.4)
• Does not provide counseling	8 (5.0)	6 (3.5)
• Needs more information	4 (2.5)	7 (4.1)
• Cannot immediately diagnose	1 (0.6)	9 (5.3)
• Needs to rule out organic cause	2 (1.3)	5 (2.9)
• Diagnostic uncertainty	3 (1.9)	3 (1.8)
• Lacks knowledge, skills, or experience	10 (6.3)	1 (0.6)
• Other	7 (4.4)	14 (8.2)
• Any physician barrier	63 (39.4)	68 (39.8)
Patient-related barriers
• Noncompliant	16 (10.0)	21 (12.3)
• Resists diagnosis	6 (3.8)	9 (5.3)
• Cannot afford treatment	5 (3.1)	7 (4.1)
• Complex condition	6 (3.8)	2 (1.2)
• Condition persists	3 (1.9)	6 (3.5)
• Drug addiction	7 (4.4)	1 (0.6)
• Suicidal	4 (2.5)	3 (1.8)
• History incomplete	2 (1.3)	3 (1.8)
• Wants physical diagnosis	2 (1.3)	1 (0.6)
• Condition is comorbid	2 (1.3)	1 (0.6)
• Other	1 (0.6)	3 (1.8)
• Any patient barrier	40 (25.0)	36 (21.1)
System access–related barriers
• Counseling	14 (8.8)	16 (9.4)
• Psychiatrist	7 (4.4)	8 (4.7)
• Laboratory results	3 (1.9)	8 (4.7)
• Specialist	1 (0.6)	4 (2.3)
• CBT provider	3 (1.9)	2 (1.2)
• Other	6 (3.8)	7 (4.1)
• Any system barrier	30 (18.8)	36 (21.1)
No response	53 (33.1)	60 (35.1)

CBT—cognitive behavioural therapy, GAD—generalized anxiety disorder, MDE—major depressive episode.
↵* Respondents might have noted more than 1 barrier; therefore, categories of “any barrier” do not total 100%.