Avaliação dos transtornos depressivos na atenção primária à saúde: performance, percepção e conhecimento dos médicos

Abstract

Depressive disorders (TDs) are highly prevalent in all populations and often lead affected individuals to seek medical care. Primary Health Care (PHC) plays a key role as gate-access to health services, having an important function in the coordination and integration of mental health services. The objectives of this study were to carry out a review of the instruments more frequently used to identify and diagnose TDs, to evaluate the performance of the screening instrument K6 in the detection of psychological distress in the general population, and to investigate the perceptions and knowledge of general medical doctors about screening tools and mental health care in patients with TDs. Three original articles were produced. In the first article, we conducted an integrative review of the main instruments used in PHC to identify and diagnose TDs, describing 22 different instruments and their specific characteristics. In the second article, we demonstrated that K6 has good performance in identifying mood disorders, with high specificity and sensitivity (88.8% and 80.2%, respectively). In the third article, we analyzed the perceptions and knowledge of general medical doctors about the use of screening instruments in PHC and found that most physicians are unaware of such tools, and also, face a scenario of work overload and challenges in the mental health care network, which makes it difficult to implement new practices. PHC plays a strategic role in the identification, diagnosis, and early treatment of mental disorders, especially depressive disorders, due to their high prevalence. However, it is necessary to integrate improvements in the quality of care by reorganizing work processes, strengthening the care network, and training professionals in the identification and treatment of depressive disorders, as well as other common mental health in the general population.