The prevelance and recognition of depression in primary care.

In a two stage study of depression, 200 patients attending primary care were randomly investigated. All patients were screened using Beck Depression Inventory (BDI) (Beck & Beamesderfer, 1974) and were interviewed using Clinical Interview for Depression (CID) (Paykel, 1985). Sixty (30%) patients crossed BDI threshold for moderate or severe depression. On CID, forty two (21%) had depression. Being women, divorced or widowed and belonging to unitary families are associated with increased depression. Unemployment and lack of confiding relationship were related to depression The more common manifestations of depression viz. depressed mood, lack of energy and fatigue, decline in work and interest and anorexia had poor discriminatory power for the diagnosis of depression. The depressed patients did not have excess nicotine or alcohol dependence. The treating physicians missed diagnosis of depression in more than two third of patients. Implication of the study for the training of primary care physicians are discussed.