A risk score to diagnose depression in general practice

Depression is a common mental health problem often seen in primary care. This study sought to determine the accuracy of five screening questions for diagnosing common mental disorders in a general practice clinic and to develop a risk score.

Three hundred and fifty patients not taking psychotropic drugs were evaluated using a combination of screening and confirmatory questions, a total symptom score, and a points system (employing multivariate statistical models) to quantify the ability of each question to detect a common mental disorder.

Different screening and confirmatory strategies resulted in different sensitivities and specificities. There was good agreement between the risk estimate produced by the point system and that produced directly by the multivariate models.

The point system developed to diagnose depression in the primary care setting is an alternative approach to currently available screening methods. It is easy to use but requires changes to the physician's approach to diagnostic certainty. The study needs to be replicated and the approach refined.