Dimensional perspective on the recognition of depressive symptoms in primary care: The Hampshire Depression Project 3

Most studies of the recognition of depression in primary care have used a categorical definition of depression. This may overstate the extent of the problem. Our objective was to investigate the relationship between severity and recognition of depression, and its modification by patient and practiti...

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Bibliographic Details
Published in:British journal of psychiatry 2001-10, Vol.179 (4), p.317-323
Main Authors: THOMPSON, CHRIS, OSTLER, KEVIN, PEVELER, ROBERT C, BAKER, NIGEL, KINMONTH, ANN-LOUISE
Format: Article
Language:English
Subjects:
Acknowledgment
Adolescent
Adult
Age
Aged
Aged, 80 and over
Anxiety
Anxiety - diagnosis
Community health care
Depression - diagnosis
Deprivation
Diagnostic Errors
Dimensional approach
Family physicians
Female
Gender
Humans
Intervention
Male
Medical diagnosis
Mental depression
Mental disorders
Mental health
Middle Aged
Patients
Physicians, Family
Primary care
Psychiatric Status Rating Scales
Psychiatry
R&D
Ratings & rankings
Research & development
Self Concept
Severity
Socioeconomic Factors
Unemployment
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Summary:Most studies of the recognition of depression in primary care have used a categorical definition of depression. This may overstate the extent of the problem. Our objective was to investigate the relationship between severity and recognition of depression, and its modification by patient and practitioner characteristics. An association study in multiple consecutive adult cohorts of 18 414 primary care consultations drawn from a representative sample of 156 general practitioners in Hampshire, UK. There was a curvilinear relationship between the severity of depression and practitioners' ratings of depression. One case of probable depression was missed in every 28.6 consultations. Anxiety and unemployment altered the chances of recognition, but age, gender and deprivation scores did not. A dimensional approach to severity of depression shows that general practitioners may be better able to recognise depression than previous categorical studies have suggested. Efforts to improve the care of depression should therefore focus on doctors who have been shown to have difficulty making the diagnosis and on improving the treatment of identified patients.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.179.4.317