General practitioners' and psychiatrists' responses to emotional disclosures in patients with depression.
OBJECTIVE
To investigate general practitioners' (GPs') and psychiatrists' responses to emotional disclosures in consultations with patients with depression.


METHODS
Thirteen patient consultations with GPs and 17 with psychiatrists were video-recorded and then analyzed using conversation analysis (CA).


RESULTS
Psychiatrists responded to patients' emotional disclosures by attempting to clarify symptoms, by rational argumentation, or by offering an interpretation of the emotions from their own perspectives. GPs responded by claiming to understand the emotions or by formulating the patients' statements, but without further exploring the emotions.


CONCLUSIONS
GPs displayed a greater engagement with patients' emotions than psychiatrists. Their approach could be described as empathic, corresponding to a mentalizing stance. The different approaches taken by psychiatrists could represent conceptual differences and might affect fruitful interdisciplinary work. Psychiatric nurses' responses to patients' emotions must also be studied to complete our knowledge from psychiatry.


CONCLUSIONS
Experiences from training in mentalization could be used to develop physicians' empathic or mentalizing approach. As most patients with depression are treated in primary care, developing GPs' mentalizing capacity instead of offering didactic training could have a substantial effect in the population.
The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark. Electronic address: adavid@sund.ku.dk.
Annette Sofie
AS
Davidsen
Department of Scandinavian Studies and Linguistics, University of Copenhagen, Denmark.
Christina Fogtmann
CF
Fosgerau
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003142:Communication; D003718:Denmark; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D030881:Disclosure; D004644:Emotions; D005260:Female; D058006:General Practice; D058005:General Practitioners; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014741:Video Recording
Conversation analysis; Depression; Emotional disclosure; Empathy; General practitioner; Mentalization; Psychiatrist; Understanding