Symptom patterns of depression in ambulatory medical and psychiatric patients

The failure of primary care physicians to recognize depressive disorders in medical patients has been attributed to the differing clinical syndromes presented by these persons in comparison with psychiatric patients. Earlier British studies have found intersector difference in the prevalence and severity of somatic, affective, and cognitive symptoms. Our investigation with American patients did not replicate these findings. The need for further research along these lines is discussed, as are the implications for assessing depression in generalist and specialist practices.