Prevalence by Self-report questionnaire and recognition by nonpsychiatric physicians

Area of Science:

• Psychiatry
• Primary Care Medicine
• Clinical Psychology

Background:

• High prevalence of depression in medical outpatients is well-documented.
• Previous studies often used subjective methods, limiting quantitative analysis.
• Physician underdiagnosis of depression in primary care settings is a significant issue.

Purpose of the Study:

• To quantify the prevalence of depression in medical outpatients using a standardized instrument.
• To assess the diagnostic accuracy of the Beck Depression Inventory (BDI) in this population.
• To evaluate the rate of underdiagnosis by primary care physicians.

Main Methods:

• A cohort of 526 medical outpatients completed the Beck Depression Inventory (BDI) self-report questionnaire.
• A subsample of 41 patients underwent psychiatric interviews for calibration.
• Medical charts were reviewed to assess physician diagnoses.

Main Results:

• The prevalence of depression was 12.2% (mild), 5.5% (moderate), and 0.6% (severe).
• Primary physicians failed to diagnose approximately 50% of patients with depression or other impairments.
• The BDI demonstrated high sensitivity as a screening test.

Conclusions:

• The Beck Depression Inventory (BDI) is an effective tool for screening depression in primary care.
• Implementing the BDI can significantly improve the recognition and diagnosis of depression by primary care physicians.
• Addressing physician underdiagnosis is crucial for better patient outcomes.