GPs’ perspectives of the challenges in diagnosing depression: a qualitative study

BACKGROUND: Depression is a leading cause of disability worldwide, with general practitioners (GPs) playing a crucial role in its identification and management. Despite this central position, GPs face challenges in diagnosing depression. Previous qualitative research has focused on clinical and interactional aspects of depression diagnosis in primary care, including uncertainty and negotiation; this study examines logistical and practical challenges in diagnosis. AIM: To explore GP perspectives of the challenges in diagnosing depression and providing initial support in primary care. DESIGN & SETTING: Qualitative study involving GPs across Scotland, the North-East of England and Northern Ireland. METHOD: Semi-structured interviews were conducted with GPs, recruited through clinical networks of the research team who were contacted via email, followed by a snowball sampling strategy. Interviews were recorded, transcribed and thematically analysed. Themes were developed to explore GPs' perspectives of the challenges in diagnosing depression. RESULTS: Ten GPs from a range of practice locations were interviewed. Three themes were developed highlighting the challenges that GPs face in diagnosing depression: (1) Complexity of presentation; (2) Constraints on access and time; (3) Continuity of care. CONCLUSION: Diagnostic challenges for depression in primary care are shaped by clinical complexity, time constraints, and continuity of care. Addressing these factors may help GPs navigate diagnostic uncertainty and provide earlier support for patients presenting with depressive symptoms.