title: Training primary care physicians in Chile in the diagnosis and treatment of depression.
abstract: OBJECTIVE
  This study evaluated the results of a brief 2-day educational training program for Chilean primary care physicians that measured changes in knowledge, attitudes and practice. This World Psychiatric Association (WPA) program was adopted to overcome diagnostic and treatment problems that are found among primary care practitioners.
  
  
  METHODS
  37 primary care physicians from two cities in Chile and 2589 patients participated. Physician's knowledge, attitudes and clinical practice were assessed 1 month prior and 1 month following the training program. In addition, the patients that visited the clinic during a typical week completed depression symptom self-ratings, including the Zung and a DSM-IV/ICD-10 major depression checklist at both times.
  
  
  RESULTS
  The results suggested that, with this group of Chilean doctors, the WPA program was effective in improving knowledge about depression and in changing some disorder-related attitudes. In addition, it had some limited impact on actual clinical practice, although the rate of diagnosis remained stable and the post-training agreement between physician diagnosis and patient self-report remained low. The physicians seemed more confident in treating patients and demonstrated increased use of antidepressant agents.
  
  
  CONCLUSIONS
  The inclusion of primary care physicians is a central component of any initiative to reduce the treatment gap and lag of depression, but their competence to play a crucial role remains limited. Further training of primary care physicians to improve the management of major depression continues to be needed.
authors.affiliation: Departamento de Psiquiatria y Salud Mental, Universidad de Concepcion, Casilla 160-C, Concepcion, Chile. bvicent@udec.cl
authors.forename: Benjamin
authors.initials: B
authors.lastname: Vicente
authors.forename: Robert
authors.initials: R
authors.lastname: Kohn
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levav
authors.forename: Francisco
authors.initials: F
authors.lastname: Espejo
authors.forename: Sandra
authors.initials: S
authors.lastname: Saldivia
authors.forename: Norman
authors.initials: N
authors.lastname: Sartorius
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002677:Chile; D003863:Depression / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010821:Physicians, Family / Q000193:education*