Patients’ perspectives on the use of the Montgomery-Asberg depression rating scale self-assessment version in primary care

Abstract

Objective: The aim of the current study was to better understand how patients with depression perceive the use of MADRS-S in primary care consultations with GPs.

Design: Qualitative study. Focus group discussion and analysis through Systematic Text Condensation.

Setting: Primary Health Care, Region Västra Götaland, Sweden.

Subjects: Nine patients with mild/moderate depression who participated in a RCT evaluating the effects of regular use of the Montgomery-Åsberg Depression Self-assessment scale (MADRS-S) during the GP consultations.

Main Outcome measure: Patients’ experiences and perceptions of the use of MADRS-S in primary care.

Results: Three categories emerged from the analysis: (I) confirmation; MADRS-S shows that I have depression and how serious it is, (II) centeredness; the most important thing is for the GP to listen to and take me seriously and (III) clarification; MADRS-S helps me understand why I need treatment for depression.

Conclusion: Use of MADRS-S was perceived as a confirmation for the patients that they had depression and how serious it was. MADRS-S showed the patients something black on white that describes and confirms the diagnosis. The informants emphasized the importance of patient-centeredness; of being listened to and to be taken seriously during the consultation. Use of self-assessment scales such as MADRS-S could find its place, but needs to adjust to the multifaceted environment that primary care provides.

Key Points

• Patients with depression in primary care perceive that the use of a self-assessment scale in the consultation purposefully can contribute in several ways. The scale contributes to

• Confirmation: MADRS-S shows that I have depression and how serious it is.

• Centeredness: The most important thing is for the GP to listen to and take me seriously.

• Clarification: MADRS-S helps me understand why I need treatment for depression.

Keywords:

• Depression
• self-assessment scale
• focus group
• primary care
• communication
• general practice
• Sweden

Acknowledgements

We thank Kimberly Kane and Christopher Pickering for useful comments on the text. We would also like to thank the participating patients in this study, although they remain anonymous.

Disclosure statement

Ethical approval Dnr 746-09, T 612-10.

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

This work was funded by Rehsam, Swedish Social Insurance Agency, RS11-013, and Region Västra Götaland.