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Depression in general practice: case thresholds and diagnosis.

L I Sireling, E S Paykel, P Freeling

    The British Journal of Psychiatry : the Journal of Mental Science
    |August 1, 1985
    PubMed
    Summary
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    General practice patients diagnosed with depression often meet psychiatric criteria but have mild, borderline disorders. Treatment approaches varied, with some patients not meeting diagnostic standards.

    Area of Science:

    • Psychiatry
    • General Practice
    • Epidemiology

    Background:

    • Depression diagnosis in general practice is complex.
    • Assessing the severity and diagnostic validity of depression in primary care is crucial.

    Purpose of the Study:

    • To evaluate general practice (GP) patients diagnosed with depression using multiple diagnostic criteria.
    • To compare diagnostic outcomes for patients receiving antidepressants, other treatments, or no specific treatment.

    Main Methods:

    • Studied three GP depressive samples: antidepressant-treated, other-treated, and untreated.
    • Applied the PSE Index of Definition, Bedford College Criteria, and Research Diagnostic Criteria (RDC).

    Main Results:

    • Most GP depressives met criteria for psychiatric disorder, often mild or borderline.

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  • Antidepressant-treated patients had a higher rate of major depression diagnoses (RDC) compared to other-treated patients.
  • A significant portion of the other-treatment group did not meet depression criteria or had non-depressive diagnoses.

    • Conclusions:

    • Most GP-treated depression cases meet psychiatric disorder criteria, though often mild.
    • Diagnostic criteria application reveals variability in depression classification within general practice.
    • Treatment allocation may influence diagnostic outcomes in primary care depression management.