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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: A powerful intervention: general practitioners' use of sickness certification in depression
Author(s): Macdonald, Sara R
Maxwell, Margaret
Wilson, Philip
Smith, Michael
Whittaker, William
Sutton, Matt
Morrison, Jill
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Keywords: Depression
Mood disorder
Primary care
Environmental medicine
Doctor-patient relationship
Mental health
Depression, Mental Treatment
Cognitive therapy.
Issue Date: 9-Aug-2012
Date Deposited: 15-May-2013
Citation: Macdonald SR, Maxwell M, Wilson P, Smith M, Whittaker W, Sutton M & Morrison J (2012) A powerful intervention: general practitioners' use of sickness certification in depression. BMC Family Practice, 13 (Article 82).
Abstract: Background: Depression is frequently cited as the reason for sickness absence, and it is estimated that sickness certificates are issued in one third of consultations for depression. Previous research has considered GP views of sickness certification but not specifically in relation to depression.This study aimed to explore GPs views of sickness certification in relation to depression.Methods: A purposive sample of GP practices across Scotland was selected to reflect variations in levels of incapacity claimants and antidepressant prescribing. Qualitative interviews were carried out between 2008 and 2009.Results: A total of 30 GPs were interviewed. A number of common themes emerged including the perceived importance of GP advocacy on behalf of their patients, the tensions between stakeholders involved in the sickness certification system, the need to respond flexibly to patients who present with depression and the therapeutic nature of time away from work as well as the benefits of work. GPs reported that most patients with depression returned to work after a short period of absence and that it was often difficult to predict which patients would struggle to return to work.Conclusions: GPs reported that dealing with sickness certification and depression presents distinct challenges. Sickness certificates are often viewed as powerful interventions, the effectiveness of time away from work for those with depression should be subject to robust enquiry.
DOI Link: 10.1186/1471-2296-13-82
Rights: © 2012 Macdonald et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The electronic version of this article is the complete one and can be found online at:
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