AIM: To study the prevalence of depression in primary care, the detection of depressive disorders by primary care physicians, and the factors that influence detection. DESIGN: Cross-sectional, descriptive study. SETTING: Gavà II Primary Care Center, in Barcelona, Spain. PARTICIPANTS: A total of 400 people between the ages of 18 and 65 years were chosen randomly from among those who attended appointments with their primary care physician. MAIN MEASURES: A sociodemographic questionnaire and the Beck Depression Inventory (BDI) screening test were administered, and the participant s medical record was reviewed. In a subsample of 40 participants, the Mini-International Neuropsychiatric Interview (MINI) was also administered. The optimum cutoff score for the BDI was estimated with reference to the MINI results. RESULTS: A cutoff score of 20/21 for the BDI had a sensitivity of 86.7% and a specificity of 92%, when the MINI score was used as a reference. The adjusted prevalence of depressive disorder in our primary care setting was 20.2% overall, 8.1% in men, and 26.8% in women (odds ratio 4.15, p < 0.01). The physician detected depressive symptoms in 55.7% of all likely cases of depression. Persons who scored >= 21 on the BDI made more visits to their primary care physician, and had more stressful life events, than those who scored 20. CONCLUSIONS: The prevalence of depression in our primary care setting is high. The disorder was underdiagnosed in as many as 44.3% of the persons likely to have depressive disorder (especially women, widows and widowers, retired persons, persons who had experienced stressful life events, and frequent users of primary care services).
AIM: To study the prevalence of depression in primary care, the detection of depressive disorders by primary care physicians, and the factors that influence detection. DESIGN: Cross-sectional, descriptive study. SETTING: Gavà II Primary Care Center, in Barcelona, Spain. PARTICIPANTS: A total of 400 people between the ages of 18 and 65 years were chosen randomly from among those who attended appointments with their primary care physician. MAIN MEASURES: A sociodemographic questionnaire and the Beck Depression Inventory (BDI) screening test were administered, and the participant s medical record was reviewed. In a subsample of 40 participants, the Mini-International Neuropsychiatric Interview (MINI) was also administered. The optimum cutoff score for the BDI was estimated with reference to the MINI results. RESULTS: A cutoff score of 20/21 for the BDI had a sensitivity of 86.7% and a specificity of 92%, when the MINI score was used as a reference. The adjusted prevalence of depressive disorder in our primary care setting was 20.2% overall, 8.1% in men, and 26.8% in women (odds ratio 4.15, p < 0.01). The physician detected depressive symptoms in 55.7% of all likely cases of depression. Persons who scored >= 21 on the BDI made more visits to their primary care physician, and had more stressful life events, than those who scored 20. CONCLUSIONS: The prevalence of depression in our primary care setting is high. The disorder was underdiagnosed in as many as 44.3% of the persons likely to have depressive disorder (especially women, widows and widowers, retired persons, persons who had experienced stressful life events, and frequent users of primary care services).
Authors: Tam K Dao; Nagy A Youssef; Raja R Gopaldas; Danny Chu; Faisal Bakaeen; Emily Wear; Deleene Menefee Journal: J Cardiothorac Surg Date: 2010-05-13 Impact factor: 1.637