Depression in primary care. A nationwide epidemiological survey.
BACKGROUND
Most epidemiological studies on depression in primary care are conducted at single sites, and variations in reported prevalence may depend on characteristics of health care services and other local factors.


OBJECTIVE
Our aim was to investigate the prevalence of depression in primary care in Italy and its association with physical illness, disability and health care utilization.


METHODS
This nationwide epidemiological study involved 191 primary care physicians (PCPs) who assessed during one index week 1896 patients aged 14 and over attending their clinics. Screening was conducted by using the General Health Questionnaire-12. Probable cases were assessed by PCPs with the WHO ICD-10 Checklist for Depression and rated for severity of physical illness.


RESULTS
The prevalence of current depression ranged between 7.8 and 9.0% in the three main Italian areas, with no significant variations. A linear increase from North to South was observed for psychological distress, disability and frequency of medical consultation. Depression was associated with severe, but not with mild or moderate physical illness. Depression was also associated with disability and accounted for an increased rate of consultation.


CONCLUSIONS
Because of the disability associated with depression and of its impact on health care utilization, guidelines and intervention strategies are needed.
Institute of Psychiatry, Bologna University, Viale Pepoli 5, 40123 Bologna, Italy. dberardi@alma.unibo.it
Domenico
D
Berardi
Giuseppe
G
Leggieri
Giuseppe Berti
GB
Ceroni
Paola
P
Rucci
Antonio
A
Pezzoli
Elisabetta
E
Paltrinieri
Natalia
N
Grazian
Giuseppe
G
Ferrari
D000293:Adolescent; D000328:Adult; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care