Symptoms associated with the diagnosis and treatment of depression in family practice

The diagnosis of depression in family practice is influenced by numerous physician and patient factors. We studied the impact of prior depression history and symptomatology on diagnosis and use of antidepressant therapy. Office visits made by 67 women diagnosed as depressed were coded for vegetative, psychological, and somatic depression-related symptoms. One third of patients diagnosed within the study period had a prior history of depression. Depressed mood and sleep disturbance were the most common symptoms on the diagnostic visit, although symptoms were heterogeneous. Most patients presented with a combination of vegetative, psychological, and/or somatic symptoms. Medication use was associated with prior history and with vegetative symptoms. Further research is needed to compare symptom presentation in recognized depressed patients to patients in whom depression is unrecognized by physicians, and to discriminate patient presentation from interview-elicited data.