When patients have psychosocial problems such as anxiety, depression or substance abuse, a general practice doctor is often the first healthcare professional they see.
A new review of studies examines how well GPs treat these conditions.
“We found no strong evidence for either the effectiveness (or ineffectiveness) of the psychosocial interventions by GPs,” wrote the review team from the Netherlands. “Of the interventions reviewed, problem-solving treatment for depression seems the most promising tool for GPs, although its effectiveness in daily practice remains to be seen.”
Problem-solving treatment is a type of talk therapy. The goal is to help patients understand that their symptoms are caused by everyday problems and to teach them ways to tackle these problems.
The review appears in the latest issue of The Cochrane Library , a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
“Many patients visit their GP because of problems that are psychosocial in origin,” according to the team led by Marcus Huibers, an assistant professor in the Department of Clinical Psychological Services at Maastricht University. “Consequently, GPs could benefit from tools to help those patients.”
In the United States, a patient's primary care physician is often a GP — generally a doctor who specializes in family medicine or general internal medicine.
The reviewers looked at 10 studies on the effectiveness of interventions by GPs for depression, smoking cessation, alcohol abuse and unexplained fatigue as well as somatization disorder, where patients have chronic, unexplained physical symptoms caused by psychological problems.
Except for problem-solving treatment for major depression, the evidence on the effectiveness of GP care for psychosocial health complaints was either limited or conflicting, the review found. However, insufficient evidence does not mean that primary care physicians should be discouraged from tending to their patients' mental health needs, the review authors said.
“The main message is that there is no reason not to start treatment for these problems with your GP,” said Nancy Stevens, M.D., professor of family medicine at the University of Washington School of Medicine in Seattle. “There is nothing in the review that says we should change what we are doing, nor are there any indications that what we are doing is harmful.”