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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 2 No. 10, October 1993   Archives  •  Online Features Original Contributions  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal The Role of Primary Care Clinician Attitudes, Beliefs, and Training in the Diagnosis and Treatment of Depression A Report From the Ambulatory Sentinel Practice Network Inc Deborah S. Main, PhD; Lawrence J. Lutz, MD, MSPH; James E. Barrett, MD; John Matthew, MD; Rebecca S. Miller, MS Arch Fam Med. 1993;2(10):1061-1066. Abstract Objective To examine the relation between primary care clinicians' attitudes, beliefs, and training and their perceptions of the importance and frequency of depression. Design A 56-item questionnaire was mailed to 226 clinicians in the Ambulatory Sentinel Practice Network Inc (ASPN), a primary care research network. Setting The ASPN, consisting of 69 primary care practices in the United States and Canada, cares for approximately 350 000 patients. Main Outcome Measure The degree to which clinician training in depression and clinician attitudes and beliefs about treating depression predict their perceptions of the importance of depression in their primary care practices. Results Results of path analysis indicate that clinician training in depression, beliefs about the burden and discomfort associated with diagnosing and treating depression, perceptions of their patients' discomfort, and self-efficacy in diagnosing and treating depression are all significantly related to clinician perceptions of whether depression was an important and frequent primary care problem. Further analysis indicates that actual prevalence of depression accounted for little variability in clinicians' beliefs and attitudes about depression. Conclusions What clinicians think their patients feel about issues on depression and how they view their own abilities may profoundly influence the degree to which they recognize depression in primary care. Understanding these factors may help explain and subsequently decrease clinician variability in the recognition of depression in primary care. Author Affiliations From the Department of Family Medicine, University of Colorado Health Sciences Center (Drs Main and Lutz and Ms Miller), and the Ambulatory Sentinel Practice Network Inc (Ms Miller), Denver; the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH (Dr Barrett); and The Health Center, Plainfield, Vt (Dr Matthew). THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES How Older Adults Combine Medical and Experiential Notions of Depression Wittink et al. Qual Health Res 2008;18:1174-1183. ABSTRACT   What Comprises Clinical Experience in Recognizing Depression?: The Primary Care Clinician's Perspective Baik et al. J Am Board Fam Med 2008;21:200-210. ABSTRACT | FULL TEXT   Physician and Patient Characteristics Associated With Discussion of Psychosocial Health During Pediatric Primary Care Visits Brown et al. CLIN PEDIATR 2007;46:812-820. ABSTRACT   Recognition of Depression in Medical Patients With Heart Failure Koenig Psychosomatics 2007;48:338-347. ABSTRACT | FULL TEXT   Practice-Based Research--"Blue Highways" on the NIH Roadmap Westfall et al. JAMA 2007;297:403-406. FULL TEXT   Factors Associated With Primary Care Clinicians' Choice of a Watchful Waiting Approach to Managing Depression Meredith et al. Psychiatr. Serv. 2007;58:72-78. ABSTRACT | FULL TEXT   Are Family Physicians Appropriately Screening for Postpartum Depression? Seehusen et al. J Am Board Fam Med 2005;18:104-112. ABSTRACT | FULL TEXT   The Recognition of Depression: The Primary Care Clinician's Perspective Baik et al. Ann Fam Med 2005;3:31-37. ABSTRACT | FULL TEXT   Prevalence and Predictors of Depression Treatment in an International Primary Care Study Simon et al. Am. J. Psychiatry 2004;161:1626-1634. ABSTRACT | FULL TEXT   Patient Beliefs Predict Response to Paroxetine Among Primary Care Patients with Dysthymia and Minor Depression Sullivan et al. J Am Board Fam Med 2003;16:22-31. ABSTRACT | FULL TEXT   Primary Care Referral of Children With Psychosocial Problems Rushton et al. Arch Pediatr Adolesc Med 2002;156:592-598. ABSTRACT | FULL TEXT   Pediatrician and Family Physician Prescription of Selective Serotonin Reuptake Inhibitors Rushton et al. Pediatrics 2000;105:82e-82. ABSTRACT | FULL TEXT   False Positives, False Negatives, and the Validity of the Diagnosis of Major Depression in Primary Care Klinkman et al. Arch Fam Med 1998;7:451-461. ABSTRACT | FULL TEXT   Practitioner Self-confidence and Patient Outcomes in Acute Low Back Pain Smucker et al. Arch Fam Med 1998;7:223-228. ABSTRACT | FULL TEXT   Management of Patients With Depression by Rural Primary Care Practitioners Hartley et al. Arch Fam Med 1998;7:139-145. ABSTRACT | FULL TEXT   Developing a Strategy for Managing Behavioral Health Care Within the Context of Primary Care Fisher and Ransom Arch Fam Med 1997;6:324-333. ABSTRACT   Depression in Rural Family Practice: Easy to Recognize, Difficult to Diagnose Susman et al. Arch Fam Med 1995;4:427-431. ABSTRACT   Physician Management Preferences and Barriers to Care for Rural Patients With Depression Rost et al. Arch Fam Med 1994;3:409-414. ABSTRACT   Physician Attitudes, Beliefs, and Training: A Partial Solution? Parchman Arch Fam Med 1993;2:1031-1032. 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