Recognition of depressive disorders by primary care providers in a military medical setting

This study examined the accuracy of military primary care providers in detecting depressive disorders in their patients. For a 5-day period, each patient who entered the primary care clinic completed the depression section of the Patient Health Questionnaire (PHQ). Appointment notes were examined for depressive disorder diagnoses and then compared with PHQ responses. Of 337 respondents, 19 (5.6%) were identified by the PHQ as meeting the criteria for major depression; 4 (21%) of these 19 were identified by their provider as having a major depressive disorder. Eighteen (5.3%) were identified as having minor depression by the PHQ; none of these individuals were identified by their provider as having minor depression. These results suggest that military primary care providers, like their civilian counterparts, are not diagnosing depressive disorders as frequently as they present. Given the financial, medical, and personal consequences of not recognizing and treating depressive disorders, suggestions for increasing appropriate depression diagnoses are discussed.