Open Access Research article

Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study

Tsuyuka Ohtsuki1, Manami Kodaka1, Rumi Sakai2, Fuminobu Ishikura3, Yoichiro Watanabe4, Anthony Mann5, Mark Haddad6, Mitsuhiko Yamada7 and Masatoshi Inagaki178*

Author Affiliations

1 Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan

2 Hyogo Mental Health Center, Kobe, Hyogo, Japan

3 Department of Functional Diagnostic Science, Division of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

4 Osaka Association of Psychiatric Clinics, Osaka, Japan

5 Department of Health Services and Population Research, Institute of Psychiatry at King's College London, London, UK

6 School of Health Sciences, City University London, London, UK

7 Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan

8 Section of Medical Research for Suicide, Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashimachi, Kodaira, Tokyo, 187-8553, Japan

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BMC Research Notes 2012, 5:441  doi:10.1186/1756-0500-5-441

Published: 16 August 2012



Under-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors’ attitude toward depression.


The inclusion criteria of participants in the present study were as follows: 1) Japanese non-psychiatric doctors and 2) attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1) a workshop to depression care for non-psychiatric doctors and 2) a general physician-psychiatrist (G-P) network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ), a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis.


We received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187) disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112) agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101) agreed. Meanwhile, 67 % of doctors (n = 126) thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly different to that of British GPs.


Japanese non-psychiatric doctors believe that depression care is beyond the scope of their duties. It is suggested that educational programs or guidelines for depression care developed in other countries such as the UK are not directly adaptable for Japanese non-psychiatric doctors. Developing a focused educational program that motivates non-psychiatric doctors to play a role in depression care is necessary to enhance recognition and treatment of depression in Japan.