Diagnosing depression among new patients in ambulatory training settings.
A research-validated instrument, based upon the Diagnostic and Statistical Manual of Mental Disorders-III, is used as a "gold standard" to compare physician assessments of depression. Twenty-seven of 294 patients (9.2 percent) presenting to three primary care clinics for the first time met clinical criteria for a depressive disorder. Although the 27 depressed patients differed from the nondepressed patients on sociodemographic characteristics, prior service utilization patterns, and clinical variables, only 7 of the 27 were diagnosed as depressed by their primary care physicians. Factors associated with accurate assessment include comment in the patient's chart of a prior psychiatric history. Many depressed patients reporting high levels of dysphoria on a screening instrument had no mood symptoms recorded on their charts.
Department of Community Medicine, University of Pittsburgh School of Medicine, PA 15261.
M
M
Block
H C
HC
Schulberg
J C
JC
Coulehan
M
M
McClelland
W
W
Gooding
D000328:Adult; D000553:Ambulatory Care; D003863:Depression / Q000175:diagnosis*; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007406:Interview, Psychological; D008297:Male