Case-finding and risk-group screening for depression in primary care.

Area of Science:

• Primary Care Medicine
• Psychiatry
• Public Health

Background:

• Routine depression screening is recommended for high-risk primary care patients.
• Effectiveness of high-risk screening versus case-finding for depression requires comparison.

Purpose of the Study:

• Compare high-risk screening with case-finding for depression identification in primary care.
• Identify specific risk groups for targeted depression detection.

Main Methods:

• Observational study in 37 Danish primary care practices.
• Inclusion of patients from 13 predefined risk groups and those suspected of depression.
• Assessment using Major Depression Inventory (MDI) and ICD-10 criteria.

Main Results:

• High-risk depression prevalence found in 672 patients across five traits.
• General practitioners (GPs) achieved 87% sensitivity and 67% specificity with case-finding.
• Including patients with other mental disorders could identify 42% more depressed individuals.

Conclusions:

• A broad case-finding approach with validation testing aids GPs in depression identification.
• Patients with other mental disorders represent a key group for unrecognized depression.
• The study does not support current central health organization screening strategies.