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Detection of depression in primary care
Marilyn J Miller1, Susan McCrone
1Maryland Veterans Affairs Health Care System, Mental Health Clinic, Circle Drive, Building 80, Perry Point, MD 21902, USA.
Military Medicine
|March 24, 2005
Summary
Primary care providers accurately diagnose depression and refer patients appropriately. This study found high agreement between primary care and mental health clinician diagnoses, supporting effective depression management in primary care settings.
Area of Science:
- Psychiatry
- Primary Care Medicine
- Mental Health
Background:
- Depression diagnosis and referral in primary care are critical for patient outcomes.
- Understanding factors influencing referral decisions is essential for optimizing mental health care access.
Purpose of the Study:
- To identify variables associated with diagnosing depressive disorders and referring patients to mental health clinicians.
- To assess the agreement between primary care provider (PCP) and mental health clinician (MHC) diagnoses of depression.
Main Methods:
- Retrospective case-control study involving 162 patients.
- Descriptive statistics and logistic regression were employed for data analysis.
Main Results:
- Referred patients were often Caucasian, middle-aged/older men with a history of depression, depressive symptoms, or stressors.
- These patients frequently had cardiovascular or cerebrovascular disease and were on multiple medications.
- Mental health clinicians agreed with PCPs' depression diagnoses in 76% of cases.
Conclusions:
- Primary care clinicians demonstrate accuracy in diagnosing depression for most patients.
- Referral patterns for psychiatric care by PCPs are generally appropriate, indicating effective initial management.