Depression diagnosis in a rehabilitation hospital

Physical rehabilitation patients frequently have extreme emotional reactions which are appropriate to their physical disability but are misdiagnosed as clinical depression. Organic illness can produce signs and symptoms which mimic clinical depression (false positives). Less frequently, clinical depressions which present atypically are not diagnosed (false negatives). To illustrate these points, 100 consecutive psychiatric consultations were reviewed to study the diagnosis of clinical depression in this setting. Diagnostic criteria for depression, specific for a physical rehabilitation population, are proposed. Consequences of the misdiagnosis of clinical depression in this setting are discussed.