Effects of training program on recognition and management of depression and suicide risk evaluation for Slovenian primary-care physicians: follow-up study

Aim To implement and evaluate an educational program for primary care physicians on recognition and treatment of depression and suicide prevention. Method The study was conducted in 3 Slovenian neighboring regions (Celje, Ravne na Koroskem, and Podravska) with similar suicide rates and other health indicators. All primary care physicians from Celje (N = 155) and Ravne na Koroskem (N = 35) were invited to participate in the educational program on depression treatment and suicide risk recognition. From January to March 2003, approximately half of them (82 out of 190; educational group) attended the program, whereas the other half (108 out of 190; control group 1) and physicians from the Podravska region (N = 164; control group 2) did not attend the program. The prescription rates of antidepressants and anxiolytics before and after the intervention were compared between the studied regions. Also, suicide rates three-years before and after the intervention were compared. Results From 2002 to 2003, there was a 2.33-fold increase in the rate of antidepressant prescriptions in the educational group (P < 0.05) and only 1.28-fold (P < 0.05) and 1.34-fold (P < 0.05) increase in control groups 1 and 2, respectively. However, the 12% decrease in suicide rate in the intervention regions was not significantly greater than the 4% decrease in the non-intervention region (P > 0.05). Conclusion Our training program was beneficial for primary care physicians' ability to recognize and manage depression. However, there was no significant decrease in local suicide rates.