title: Understanding the prescription of antidepressants: a Qualitative study among French GPs.
abstract: BACKGROUND
  One-tenth of France's population is prescribed at least one antidepressant, primarily by General Practitioners. The reasons for this high prescription rate remain unclear. One-third of these prescriptions may not comply with clinical practice guidelines, and 20% are potentially unrelated to any psychiatric condition. Our aim was to explore how GPs declare they use antidepressants in daily practice and understand their reasons for prescribing them.
  
  
  METHODS
  Six focus groups including a total of 56 rural and urban GPs, with four interviews were performed. The topic guide focused on reasons for prescribing antidepressants in various primary care situations. Phenomenological analysis was performed by four researchers.
  
  
  RESULTS
  Antidepressants were seen as useful and not harmful. Personal assessment based on experience and feeling determined the GPs' decisions rather than the use of scales. Twenty-four "non-psychiatric" conditions possibly leading to prescription of antidepressants in primary care were found.
  
  
  CONCLUSIONS
  The GPs reported prescribing antidepressants for a wide range of conditions other than depression. The GPs' decision making process is difficult and complex. They seemed to prefer to focus on their difficulties in diagnosing depression rather than on useless overtreatment. Instead of using the guidelines criteria to detect potential cases of useful prescription, physicians tend to use their own tools based on gut feelings, knowledge of the patient and contextual issues.
authors.affiliation: Department of General Practice, Rouen University and CIC Inserm 0204, Rouen University, Rouen, France. alain.mercier@univ-rouen.fr
authors.forename: Alain
authors.initials: A
authors.lastname: Mercier
authors.forename: Isabelle
authors.initials: I
authors.lastname: Auger-Aubin
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lebeau
authors.forename: Paul
authors.initials: P
authors.lastname: Van Royen
authors.forename: Lieve
authors.initials: L
authors.lastname: Peremans
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000592:standards / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D005602:France; D058005:General Practitioners / Q000523:psychology* / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs / Q000627:therapeutic use; D036301:Qualitative Research
chemical_list: D000928:Antidepressive Agents; D055553:Prescription Drugs