Bridging the communication gap between physicians and their patients with physical symptoms of depression.

Primary care physicians must understand and effectively communicate to their patients with depression the importance and process of managing the illness because these clinicians are usually the first to diagnose and treat patients with depression, especially depression with physical symptoms. Diagnosing and treating depression presents physicians and patients with a number of challenges, many of which arise because doctors and patients do not share enough information with one another. To improve the management of depression, physicians should explain how depression is diagnosed, how the individual's depression will be treated, how treatment success is defined, what treatment side effects might occur and how they will be addressed, and why adhering to the treatment regimen is important. Unfortunately, patients might not remember everything their physicians say during office visits, and physicians might forget to mention some instructions. To make sure that patients understand as much about depression and its treatment as possible, physicians should provide patients with resources such as pamphlets, videotapes, names of books, and Web site addresses and, if possible, enlist a mental health professional to educate the patient and provide psychotherapy. Physicians should encourage patients to become actively involved in their treatment by recording their symptoms, goals of therapy, side effects, and changes in their condition and by voicing their concerns. If primary care physicians and patients with depression improve their communication, they will ultimately strengthen the doctor-patient relationship and improve the patients' depressive symptoms and quality of life.