PCC-Framework.

ObjectivesDepressive disorders are common in the primary care setting. Despite its high prevalence, depression treatment in primary care is less guideline-oriented compared to specialized settings, which often makes it less efficient. Current research has focused on explanations on the practitioner’s side but has neglected the patient’s perspective and its effect on treatment largely.MethodsWe conducted a scoping review on the electronic databases Medline and Psycinfo. Eligible publications contained information of the patients’ perspective on depression treatment in primary care in OECD member states. Publications until August 2nd 2023 were considered.ResultsAfter the removal of duplicates, the search yielded 14.059 articles, of which 232 were included. Current literature focuses on behavioral and obvious measures like satisfaction, and on patient-sided barriers and facilitators to adherence. Other treatment-related behaviors are less researched. Patients with undiagnosed depression often report exclusively or mainly physical symptoms in general practice.ConclusionThis review provides a comprehensive framework for the concept. Research on barriers and facilitators to depression treatment in primary care is still inconclusive. Educating patients and addressing stigmatizing beliefs are promising targets to promote the seeking out, initiation of, and adherence to treatment. Being aware of a hidden depression when somatic symptoms are present, can help to detect more cases.RegistrationThis review is registered via OSF (https://osf.io/p9rnc).研究目标：抑郁障碍在基层医疗场景中十分常见。尽管患病率颇高，但基层医疗中的抑郁治疗相较于专科诊疗场景，更缺乏指南指导性，往往导致治疗效率低下。现有研究多聚焦于从业者层面的影响因素，却在很大程度上忽视了患者视角及其对治疗的作用。 研究方法：本研究针对MEDLINE与PsycINFO两大电子数据库开展范围综述（scoping review）。纳入的文献需包含经济合作与发展组织（Organisation for Economic Co-operation and Development，OECD）成员国患者对基层医疗抑郁治疗的相关视角信息，检索时限截至2023年8月2日。 研究结果：去重后共检索得到14059篇文献，最终纳入232篇。现有文献多围绕满意度等行为性、显性指标，以及影响患者治疗依从性的患者层面障碍与促进因素展开研究，其余与治疗相关的行为则较少被探讨。未被确诊的抑郁患者在全科诊疗中往往仅或主要主诉躯体症状。 研究结论：本综述为该主题构建了全面的分析框架。目前针对基层医疗抑郁治疗障碍与促进因素的研究仍未得出定论。对患者开展健康教育、纠正其污名化观念，是提升患者主动就医、启动治疗与维持治疗依从性的可行干预方向。当患者出现躯体症状时，警惕隐匿性抑郁，有助于发现更多未被确诊的抑郁病例。 研究注册：本综述已通过OSF平台（https://osf.io/p9rnc）完成注册。