Referral of patients with depression to mental health care by Dutch general practitioners: an observational study
Open accessAbstract
BACKGROUND: Depression is a common illness, often treated in primary care. Guidelines provide recommendations for referral to mental health care. Several studies investigated determinants of referral, none investigated guideline criteria as possible determinants.We wanted to evaluate general practitioner's referral of depressed patients to mental health care and to what extent this is in agreement with (Dutch) guideline recommendations. METHODS: We used data of primary care respondents from the Netherlands Study of Depression and Anxiety with major depressive disorder in the past year (n = 478). We excluded respondents with missing data (n = 134). Referral data was collected from electronic patient files between 1 year before and after baseline and self report at baseline and 1-year follow-up. Logistic regression was used to describe association between guideline referral criteria (e.g. perceived need for psychotherapy, suicide risk, severe/chronic depression, antidepressant therapy failure) and referral. RESULTS: A high 58% of depressed patients were referred. Younger patients, those with suicidal tendency, chronic depression or perceived need for psychotherapy were referred more often. Patients who had used ≥2 antidepressants or with chronic depression were more often referred to secondary care. Referred respondents met on average more guideline criteria for referral. However, only 8-11% of variance was explained. CONCLUSION: The majority of depressed patients were referred to mental health care. General practitioners take guideline criteria into account in decision making for referral of depressed patients to mental health care. However, other factors play a part, considering the small percentage of variance explained. Further research is necessary to investigate this.
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Our patient group appeared to be representative for the patient population expected in outpatient specialized mental health care, which includes patients presenting with co-morbid disorders, moderate to (very) severe depressive symptoms and serious impairments in general functioning.
“our patient group did appear to be representative for the patient population that is expected in outpatient specialized mental health care, which includes patients presenting with co-morbid disorders, moderate to (very) severe depressive symptoms and serious impairments in general functioning (Piek et al., 2011).”
From Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care (2016) · cites this paper as Piek et al., 2011
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- Authors
- Piek, E., van der Meer, K., Penninx, B. W., Verhaak, P. F., & Nolen, W. A.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Piek, Ellen
- Venue
- BMC Family Practice
- Published
- 2011-05-26
- Volume
- 12
- Issue
- 1
- Pages
- 41-41
- ISSN
- 1471-2296 (ISSN-L)
- PMC
- PMC3119074
- OpenAlex
- W2142512268
- Cited by
- 28
- References
- 24
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 2 · 2014: 4 · 2013: 1 · 2012: 4
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Family Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- Stanley Medical Research Institute
- European Commission
- Universiteit Leiden (10‐000‐1002)
- ZonMw (10‐000‐1002)
- Vrije Universiteit Amsterdam
- GGZ inGeest
- Rivierduinen
- GGZ Friesland
- GGZ Drenthe
- Nederlands Instituut voor Onderzoek van de Gezondheidszorg (10-000-1002)
- Trimbos-instituut
- Leids Universitair Medisch Centrum
- Universitair Medisch Centrum Groningen
- Servier
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- depression, general practitioners, guideline adherence, referral criteria, chronic depression, suicide risk, antidepressant treatment failure, primary care, secondary care
- MeSH terms
- Adult, Chronic Disease, Decision Making, Depression, Female, Humans, Male, Mental Health Services, Middle Aged, Netherlands, Practice Patterns, Physicians', Psychotherapy, Referral and Consultation, Logistic Models, Practice Guidelines as Topic, Guideline Adherence, Patient Preference, General Practitioners, Suicidal Ideation
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