The prevalence of depression in women in an ambulatory care setting

Depression is a complex, debilitating illness that is frequently present in a medically ill population. Assessment of depression presents a challenge to the nurse practitioner whose patient may not describe a depressed mood, but presents with multiple somatic complaints that do not respond to usual interventions. A two-phase descriptive survey that examined the incidence and severity of depressive symptomatology in 30 women on their initial visits to a general medical clinic is reviewed. In addition to an evaluation of depression, somatic symptoms and demographic data relevant to the assessment of depression were obtained. Fifty percent (15) of the women exhibited symptoms of depression as measured by the Beck Depression Inventory. Significant positive correlations were found between depression, stress, level of somatic symptoms, pain and family history of depression. A chart review was done four months subsequent to administration of the Beck Depression Inventory for data concerning care. Significant negative correlations were found between depression and number of clinic visits. The chart review revealed that the depression experienced by the 15 women was apparently unrecognized and untreated. The diagnostic criteria for major depression and the medical conditions that may present with depressive symptoms are covered to assist NPs in recognizing depression. Drugs that can aggravate an existing depression or cause depression as a side effect are listed. The short form of the Beck Depression Inventory is provided to help NPs uncover hidden depressive symptoms in their clients.