Making the diagnosis of depression in the primary care setting

Making the diagnosis of depression in the primary care setting represents a challenge and an opportunity. With the numerous cultural, administrative, social, and financial obstacles to the assessment and management of mental disorders in primary care, it is a small wonder that so much treatment of depression actually does occur. However, much depression is missed, and even when the diagnosis is not missed, many depressed patients do not receive adequate treatment. This article reviews the different depressive conditions of importance that present in primary care, discusses complexities of differential diagnosis, and underscores the importance of the medical interview itself for eliciting relevant data, developing rapport, and educating the patient about the key issues of importance relevant to the management of depression.