title: Prevalence, nature, and comorbidity of depressive disorders in primary care.
abstract: This article examines the prevalence, nature, and comorbidity of depressive disorders using DSM-III-R criteria among patients recruited from the waiting rooms of family physicians. A total of 1928 family practice patients completed a screening form including the Center for Epidemiologic Studies-Depression Scale (CES-D), and patients with elevated CES-D scores were oversampled for possible interviews using the Structured Clinical Interview for the DSM-III-R (SCID). In the resulting weighted sample of 425, a prevalence of 13.5% was obtained for major depression and 22.6% for all depressive disorders. Over 40% of the patients with major depressive disorder (MDD) were only mildly depressed. Gender and other demographic variables failed to distinguish depressed patients, but a variety of self-ratings did. Depression was associated with comorbid anxiety disorders and substance abuse. Results are discussed in terms of the implications of depression in primary care as a public health problem, but also in terms of some diagnostic issues, particularly the use of an impairment criterion for major depression.
authors.affiliation: Department of Family Practice, University of Michigan Medical Center, Ann Arbor 48109-0118.
authors.forename: J C
authors.initials: JC
authors.lastname: Coyne
authors.forename: S
authors.initials: S
authors.lastname: Fechner-Bates
authors.forename: T L
authors.initials: TL
authors.lastname: Schwenk
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011320:Primary Health Care; D011594:Psychometrics; D011602:Psychophysiologic Disorders / Q000453:epidemiology* / Q000523:psychology; D013001:Somatoform Disorders / Q000453:epidemiology* / Q000523:psychology