Barriers to the diagnosis and treatment of depression in Jordan. A nationwide qualitative study.
BACKGROUND
Depression is one of the most common causes of morbidity in developing countries. It is believed that there are many barriers to diagnosis and treatment in the primary care setting, but little research exists.


METHODS
Five focus groups were conducted with the goal of exploring themes related to barriers to the diagnosis and treatment of depression, with a purposeful nationwide sample of 50 primary health care providers working in the public health clinics of the Jordanian Ministry of Health (MOH). Participant comments were transcribed and analyzed by the authors, who agreed on common themes.


RESULTS
Lack of education about depression, lack of availability of appropriate therapies, competing clinical demands, social issues, and the lack of patient acceptance of the diagnosis were felt to be among the most important barriers to the identification, diagnosis, and treatment of patients with depression in this population.


CONCLUSIONS
Continuing medical education for providers about depression, provision of counseling services and antidepressant medications at the primary care level, and efforts to destigmatize depression may result in increased rates of recognition and treatment of depression in this population. Systematizing traditional social support behaviors may be effective in reducing the numbers of patients referred for medical care.
Nasir
Laeth S
LS
Department of Family Medicine, University of Nebraska, Omaha, NE 68198-3075, USA. lnasir@unmc.edu
Al-Qutob
Raeda
R
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003376:Counseling / Q000592:standards; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000193:education / Q000592:standards; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000928:Antidepressive Agents