Longstanding disease, disability or infirmity and depression in primary care

Current evidence suggests that depression is much more prevalent among those with chronic medical conditions compared to the general population. Depression will rank second to cardiovascular disease as a global cause of disability by 2020. With ageing of the population physicians are called upon to treat a higher percentage of patients with chronic medical illness.

To assess the prevalence and incidence of depression and likelihood for new-onset depression in patients with self-reported longstanding disease, disability or infirmity in the sample of primary care attendees.

Consecutive family medicine practice attendees aged 18 to 75 years were recruited and followed up after six months. Presence of longstanding disease, disability or infirmity was recorded.

Prevalence of major depression was 8.9% in the group of patients reporting longstanding disease compared to 3.1% in the group without longstanding disease. Incidence of major depression after 6 months was 2.7% in the group with longstanding disease and 0.9% in the group without longstanding disease. For the patients with longstanding disease at the baseline it was almost 4 times more likely to have major depression after 6 months than for patients who did not report any longstanding disease at the baseline.

The associations between longstanding disease and depression are important in primary care setting.