Prevalence of depression among outpatients visiting a general internal medicine polyclinic in rural Japan.
OBJECTIVE
In Europe and the US, primary care has been anticipated in identifying untreated depression. Findings show a high prevalence of depression in such settings. However, the prevalence of depression in an internal medicine clinic in a rural area of Japan, which has a role in primary care, is unclear.


METHODS
The prevalence of depression and comorbid psychiatric disorders among outpatients of an internal medicine clinic in a rural general hospital was measured by a structured interview using the Mini International Neuropsychiatric Interview. Outpatients were recruited consecutively and stratified by Patient Health Questionnaire-9 (PHQ-9) scores. Among 598 outpatients, we interviewed 75 randomly selected patients and 29 whose results of the PHQ-9 were positive. We estimated prevalence of depressive episode using age, sex, physical findings by internal medical doctors and PHQ-9 scores as covariates.


RESULTS
The estimated prevalence of major and minor depressive episodes were 7.4% [95% confidence interval (CI): 3.4%-11.4%] and 6.8% (95% CI: 2.6%-10.9%), respectively. Among major depressed patients, 71.4% had current suicidal ideation.


CONCLUSIONS
Given the high rate of depression and suicidality, identification of depression and collaboration between internal medical doctors in a rural area of Japan and mental health professionals are needed.
Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira City, Tokyo, Japan. minagaki@ncnp.go.jp
Masatoshi
M
Inagaki
Tsuyuka
T
Ohtsuki
Naohiro
N
Yonemoto
Yuetsu
Y
Oikawa
Mie
M
Kurosawa
Kumiko
K
Muramatsu
Toshi A
TA
Furukawa
Mitsuhiko
M
Yamada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D007388:Internal Medicine; D007406:Interview, Psychological; D007564:Japan / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012424:Rural Population / Q000706:statistics & numerical data; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult