[Dysthymic disorder in primary health care]

The aim of this study was to investigate the epidemiological and clinical characteristics of dysthymic disorder of the primary health care level.

Parts of the Composite International Diagnostic Interview (i.e. sections on demographic variables and depressive and dysthymic disorders) the General Health Assessment Form, the Brief Disability Questionnaire, and a Patient Assessment Form were applied to 1997 consecutive patients seen by primary care physicians in 10 cities.

The frequency of dysthymic disorder according to DSM-IV criteria in the primary care patients studied was 3.5%. "Fatigue or loss of energy", "diminished ability to think or concentrate", "indecisiveness", "insomnia" and "hopelessness" were the most frequent symptoms. 73.9% of patients with dysthymic disorder also had a chronic disorder and 78.3% of patients with dysthymic disorder met the criteria for major depressive disorder. 71.4% of patients with dysthymic disorder presented only somatic complaints to general practitioners. Disability ratios were higher in patients with dysthymic disorder than in patients without. General practitioners recognised depression in only 13.8% of patients with dysthymic disorder.

General practitioners can not recognise dysthymic disorder in primary health care patients. This result emphasises the need for research on the failure to recognise dysthymic disorder in primary health care patients.