[A screening test for depression in general practice. The COOP/WONCA chart]

Depressed patients in general practice may be difficult to identify. Questionnaires may be used for screening but some of the existing instruments are difficult to use and have only to a limited degree been introduced in general practice. In this study 798 patients' answers to the COOP/WONCA chart "Feelings" were compared to GPs' diagnosis according to ICD-10 criteria for depressive single episode (F32). At cut-off2/3 (slight/moderate problems) the chart had a sensitivity of 89% (76-100%) and specificity of 75% (72-78%). The predictive value of a positive test was not higher than 33% for any cut-off point and the predictive value of a negative test never less than 98%. A two-phased diagnostic strategy with the COOP/WONCA chart as step one is suggested as a possible and relatively simple way to optimize recognition of depressive patients in general practice.