title: Treatment and follow-up of anxiety and depression in clinical-scenario patients: survey of Saskatchewan family physicians.
abstract: OBJECTIVE
  To explore family physicians' recommendations for treatment of, and number of weeks to first follow-up visit for, clinical-scenario patients presenting with symptoms of either a major depressive episode (MDE) or generalized anxiety disorder (GAD), as well as physicians' perceived barriers to optimal care for these patients.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Saskatchewan.
  
  
  METHODS
  A total of 331 family physicians practising in Saskatchewan as of December 2007.
  
  
  METHODS
  Type of treatment and number of weeks to first follow-up visit recommended for clinical-scenario patients, as well as family physicians' barriers to providing optimal care.
  
  
  RESULTS
  The response rate was 49.7% (331 of 666 surveys returned). Most physicians recommended treatment of the GAD-scenario patient (93.7%) and the MDE-scenario patient (90.1%). Most physicians recommended immediate (65.6%) rather than delayed (28.1%) treatment of the GAD-scenario patient, and immediate (55.6%) rather than delayed (34.5%) treatment of the MDE-scenario patient. Pharmacotherapy alone (26.3%) was the most commonly recommended immediate treatment of the GAD-scenario patient; combination pharmacotherapy and counseling (15.8%) was the most commonly recommended immediate treatment of the MDE-scenario patient. Most physicians recommended that the first follow-up visit occur within 2 weeks for the GAD (79.4%) and the MDE (82.5%) clinical-scenario patients. Physicians were more likely to identify themselves rather than patients and the health care system as barriers to providing optimal care to the GAD (39.4%) and the MDE (39.8%) clinical-scenario patients.
  
  
  CONCLUSIONS
  Most family physicians recommend immediate treatment and early follow-up for patients presenting with symptoms of GAD or MDE. Physician-related barriers outweigh patient and health system barriers to providing optimal care to patients with common psychiatric disorders.
authors.affiliation: Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, 103 Wiggins Rd, Saskatoon, SK S7N 0W8. julie.kosteniuk@usask.ca
authors.forename: Julie
authors.initials: J
authors.lastname: Kosteniuk
authors.forename: Debra
authors.initials: D
authors.lastname: Morgan
authors.forename: Carl
authors.initials: C
authors.lastname: D'Arcy
mesh_terms: D000328:Adult; D001007:Anxiety / Q000188:drug therapy* / Q000628:therapy; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000628:therapy; D003937:Diagnosis, Differential; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012525:Saskatchewan; D011795:Surveys and Questionnaires; D013997:Time Factors