自殺予防対策の一環としての一般診療所医師に対するうつ病診療調査

A Survey of How Primary-care Doctors Deal with Cases of Depression：Their role in suicide prevention

抄録

　一般診療所医師300名を対象として，うつ病診療についてアンケート調査を行った。その結果，139名から回答が得られた(回収率46.3％)。一般診療所受診者でうつ状態と判断される割合は全外来患者の2.4％(95％信頼性区間：1.3～3.6％)と推定された。この数値とプライマリケアにおけるうつ病有病率についての文献値などから，一般診療医師によるうつ病検出力は，高々20％前後と考えられた。うつ病研修を受けた者はうつ病診療にかかわる割合が高く(p＜0.001)，うつ病診療にかかわった者は自殺予防についての問題意識が高かった (p＜0.0001)。一般科医師に対するうつ病・自殺予防研修について考察した。

Summary

　300 primary-care doctors were sent a questionnaire sheet about 1)their practice in case of depression and 2)the need for developing their skills for dealing with cases of depression. 139 answered (response rate：46.3％). Primary-care doctors diagnosed 2.4％ (95％ reliability range：1.3～3.6％) of patients who visited their clinics with somatic complaints as being depressed. With this result and literature data on the prevalence of depression in primary-care settings, the estimated sensitivity of primary-care doctors’ diagnosis for depression was around 20%, even when all of their detected patients were truly depressed. Doctors who had received training or had attended lectures on depression practice found and treated more depressive patients than those who had not (p＜0.001). Those who treated depressive patients perceived the importance of suicide prevention more seriously than those who did not (p＜0.001). Trainings and lectures for primary-care doctors on dealing with cases of depression may improve their detection of depression and their attitude toward suicide prevention.