# Beyond the medical file: A scoping review on patients’ perspectives on depression treatment in primary care

## TL;DR

This review explores how patients view depression treatment in primary care, highlighting gaps in understanding and suggesting ways to improve care.

## Contribution

The study provides a comprehensive framework focusing on patient perspectives, which are often overlooked in depression treatment research.

## Key findings

- Current research mainly focuses on patient satisfaction and barriers to treatment adherence.
- Undiagnosed depression is often reported through physical symptoms in primary care.
- Educating patients and addressing stigma are key to improving treatment engagement.

## Abstract

Depressive disorders are common in the primary care setting. Despite its high prevalence, depression treatment in primary care is less guideline-oriented compared to specialized settings, which often makes it less efficient. Current research has focused on explanations on the practitioner’s side but has neglected the patient’s perspective and its effect on treatment largely.

We conducted a scoping review on the electronic databases Medline and Psycinfo. Eligible publications contained information of the patients’ perspective on depression treatment in primary care in OECD member states. Publications until August 2nd 2023 were considered.

After the removal of duplicates, the search yielded 14.059 articles, of which 232 were included. Current literature focuses on behavioral and obvious measures like satisfaction, and on patient-sided barriers and facilitators to adherence. Other treatment-related behaviors are less researched. Patients with undiagnosed depression often report exclusively or mainly physical symptoms in general practice.

This review provides a comprehensive framework for the concept. Research on barriers and facilitators to depression treatment in primary care is still inconclusive. Educating patients and addressing stigmatizing beliefs are promising targets to promote the seeking out, initiation of, and adherence to treatment. Being aware of a hidden depression when somatic symptoms are present, can help to detect more cases.

This review is registered via OSF (https://osf.io/p9rnc).