TY - JOUR T1 - Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies JF - British Journal of General Practice JO - Br J Gen Pract SP - e538 LP - e546 DO - 10.3399/bjgp17X691889 VL - 67 IS - 661 AU - Elizabeth Ford AU - Suzanne Lee AU - Judy Shakespeare AU - Susan Ayers Y1 - 2017/08/01 UR - http://bjgp.org/content/67/661/e538.abstract N2 - Background Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs.Aim This review aimed at synthesising the available information from qualitative studies on GPs’ attitudes, recognition, and management of perinatal anxiety and depression.Design and setting Meta-synthesis of the available published qualitative evidence on GPs’ recognition and management of perinatal anxiety and depression.Method A systematic search was conducted on Embase, Medline, PsycInfo, Pubmed, Scopus, and Web of Science, and grey literature was searched using Google, Google Scholar, and British Library EThOS. Papers and reports were eligible for inclusion if they reported qualitatively on GPs’ diagnosis or treatment of perinatal anxiety or depression. The synthesis was constructed using meta-ethnography.Results Five themes were established from five eligible papers: labels: diagnosing depression; clinical judgement versus guidelines; care and management; use of medication; and isolation: the role of other professionals. GPs considered perinatal depression to be a psychosocial phenomenon, and were reluctant to label disorders and medicalise distress. GPs relied on their own clinical judgement more than guidelines. They reported helping patients make informed choices about treatment, and inviting them back regularly for GP visits. GPs sometimes felt isolated when dealing with perinatal mental health issues.Conclusion GPs often do not have timely access to appropriate psychological therapies and use several strategies to mitigate this shortfall. Training must focus on these issues and must be evaluated to consider whether this makes a difference to outcomes for patients. ER -