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Case-finding instruments for depression in primary care settings

C D Mulrow1, J W Williams, M B Gerety

  • 1Audie L. Murphy Memorial Veterans Affairs Hospital, San Antonio, Texas, USA.

Annals of Internal Medicine
|June 15, 1995
PubMed
Summary
This summary is machine-generated.

Several screening tools can help primary care providers identify patients with major depression. These case-finding instruments have similar performance, so choose based on practical factors like time and additional uses.

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Area of Science:

  • Primary Care Medicine
  • Psychiatry
  • Clinical Diagnostics

Background:

  • Major depression is a prevalent condition often undiagnosed in primary care.
  • Effective case-finding instruments are crucial for timely diagnosis and treatment initiation.

Purpose of the Study:

  • To evaluate the utility of various case-finding instruments for identifying major depression in primary care settings.
  • To compare the diagnostic performance characteristics of available screening tools.

Main Methods:

  • Systematic literature search of MEDLINE and bibliographies.
  • Inclusion of studies conducted in primary care with unselected patients.
  • Comparison of case-finding instruments against accepted diagnostic criterion standards for major depression.

Main Results:

  • 18 studies assessed 9 case-finding instruments in over 15,000 patients.
  • Instruments varied in length (2-28 questions) and administration time (2-6 minutes).
  • Overall sensitivity was 84% and specificity was 72%; no significant differences were found between instruments.

Conclusions:

  • Multiple instruments demonstrate reasonable operating characteristics for detecting major depression in primary care.
  • Instrument selection should consider feasibility, administration/scoring time, and potential for monitoring treatment response.
  • These tools can aid primary care clinicians in identifying patients needing further evaluation for major depression.