Screening depression in primary care: back to the basics with a new tool

Two depression inventories were used to screen 377 family practice patients. One, the Self-Rating Depression Scale (SDS), assesses major symptomatology; it is the depression inventory most frequently used in family practice. The other, the Depression Adjective Checklist (DACL), assesses mood only and has not been previously reported in the family medicine literature. Forty-one percent of the patients who completed the SDS rated themselves at least mildly depressed; 37% scored in the same range on the DACL. Four percent of the patients scored in the severe depression range on the SDS, while 15% scored in the severe depression range on the DACL. Residents treating these patients, however, failed to diagnose depression in more than 85% of the patients who had rated themselves as at least mildly depressed on either inventory. The residents also failed to diagnose depression in more than 70% of those who had rated themselves as severely depressed. Teaching and research implications are discussed.