Public awareness about depression: The effectiveness of a patient guideline

Objective: To evaluate the effectiveness of a patient guideline for educating the public in the recognition and treatment of depression. Method: Lay subjects were interviewed regarding their knowledge and beliefs about depression through the use of a semi-structured questionnaire, They were asked to "think aloud" while evaluating two clinical scenarios about depression, both with and without the use of a patient guideline. All interviews were audio taped, transcribed, and analyzed for subjects' thought processes and accuracy of responses in the presence and absence of the guideline. Results: Subjects with no prior history of depression identified fewer symptoms of depression listed in the patient guideline than did subjects with a history of depression. In the absence of the guideline, only 50% and 38% of subjects provided accurate diagnosis of depression for the simple and complex problems respectively. In the presence of the guideline, 92% and 83% of subjects provided an accurate diagnosis of depression for the simple and complex problems respectively. Conclusions: Lay people have a limited knowledge of depression and its treatment, and are less able to recognize symptoms of depression without the help of patient guideline. The guideline primes lay people to better recognize these symptoms and their relationship to diagnosis. This level of understanding about depression by lay people will facilitate improved communication between physicians and their patients.