Abstract
OBJECTIVES: To find whether the diagnosis-therapy approach of doctors to people with symptoms of anxiety-depression differs depending on whether the patient is a man or a woman. DESIGN: Crossover, descriptive study through a postal questionnaire, based on clinical cases. SETTING: Primary Care (PC) in Castilla-La Mancha. PARTICIPANTS: PC doctors working in the public domain. MEASUREMENTS AND MAIN RESULTS: We designed two models of questionnaire which only varied in the sex of the patient. Each model consisted of five clinical hypotheses, two on anxiety-depression and three others, whose aim was to mask the first two, on organic pathology. The sample was divided into two halves, with a different model of questionnaire placed in each half. We received back 273 (34.2%) of the 800 questionnaires sent out. Average age was 41, and 70.4% were men. In hypothesis 1, which analysed the therapeutic attitude to a patient with various episodes of atypical "knotting sensation" precordialgia, through ECG, normal examination and analysis, we found that in 77.2% of women, against 58.5% of men, treatment with anxiolytic drugs was prescribed (p < 0.01, chi 2 = 9.97). Psychological support at the consultation was opted for in 52.1% of women against 33.9% of men (p < 0.01, chi 2 = 7.89). However, doctors opted to refer to the cardiologist 9.5% of women against 24.5% of men (p < 0.01, chi 2 = 10.01). In hypothesis 2, doctors were asked about their first diagnosis of a smoking patient with asthenia, anorexia, difficulties in concentration and various months of non-specific sick feelings. 55.7% of women were diagnosed as having an anxiety-depression profile against 34.3% of men (p < 0.01, chi 2 = 13.67). The doctor's sex in hypothesis 2 led to no significant differences. CONCLUSIONS: The approach of primary care doctors to patients with symptoms of anxiety and depression differs with the sex of the patient. We prescribe more anxiolytic drugs, give more psychological support and think more of functional causes when our patient is a woman.