Article1995

Recognition, management, and outcomes of depression in primary care

513 citations0/0 files storedArchives of Family Medicine

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Mental Health Treatment and Access Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Treatment of Major Depression

Abstract

OBJECTIVE: To evaluate the recognition, management, and outcomes of depressed patients presenting in primary care. DESIGN: Epidemiologic survey with 12-month follow-up. SETTING: Primary care clinics of a staff-model health maintenance organization. PATIENTS AND MAIN OUTCOME MEASURES: Consecutive primary care attenders aged 18 to 65 years (n = 1952) were screened using the 12-item General Health Questionnaire (GHQ-12), and a stratified random sample (n = 373) completed a psychiatric assessment, including the Composite International Diagnostic Interview (CIDI), the 28-item GHQ, and a brief self-rated disability questionnaire (BDQ). Three-month follow-up assessment (n = 347) repeated the GHQ-28 and BDQ, and 12-month follow-up (n = 308) repeated the CIDI, GHQ-28, and BDQ. Use of psychotropic drugs and mental health services was assessed using computerized pharmacy and visit registration records. RESULTS: Structured interviews found 64 cases of current major depression (weighted prevalence, 6.6%) and 58 cases of current subthreshold depression (weighted prevalence, 8.8%). Of those with major depression, 64% (n = 41) were recognized as psychologically distressed by the primary care physician, 56% (n = 36) filled at least one antidepressant prescription during the next 3 months, and 39% (n = 25) made at least one specialty mental health visit. Compared with recognized cases, those with unrecognized major depression were less symptomatic at baseline (GHQ-28 score, 15.31 vs 11.07; P = .006) but showed a similar rate of improvement over 12 months (F test for difference in slopes, P = .93). CONCLUSIONS: While many depressed primary care patients may go unrecognized and untreated, this group appears to have milder and more self-limited depression. A narrow focus on increased recognition may not improve overall outcomes. Treatment resources might be best directed toward more intensive follow-up and relapse prevention among those now treated.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 513 citations exist upstream.

Cited by

1999Awareness, diagnosis, and treatment of depression 2006Collaborative care for depression in primary care 2006Changing Profiles of Service Sectors Used for Mental Health Care in the United States 2001Cost-effectiveness of Practice-Initiated Quality Improvement for Depression 2000Randomized Trial of a Depression Management Program in High Utilizers of Medical Care 2011Depression and suicide ideation among students accessing campus health care.2009Study of the Discriminative Validity of the PHQ-9 and PHQ-2 in a Sample of Brazilian Women in the Context of Primary Health Care 1999Primary Care Physicians' Approach to Depressive Disorders: Effects of Physician Specialty and Practice Structure

Imported from OpenAlex (CC0) — nothing here is generated.