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Is depression under-recognised and undertreated?

Y Lecrubier1

  • 1INSERM U302, Hôpital de la Salpêtrière, Paris.

International Clinical Psychopharmacology
|November 17, 1998
PubMed
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General practitioners (GPs) often miss diagnosing depression in patients, despite high prevalence. Early recognition and accurate diagnosis are crucial for effective mental health treatment in primary care settings.

Area of Science:

  • Psychiatry
  • General Practice
  • Epidemiology

Background:

  • Most patients with psychiatric disorders consult their general practitioner (GP) annually.
  • Depression and depressive spectrum disorders are highly prevalent in primary care settings.

Purpose of the Study:

  • To assess the recognition and diagnosis rates of depressive disorders by GPs.
  • To identify factors influencing the recognition and treatment of depression in primary care.

Main Methods:

  • Analysis of data from the World Health Organization (WHO) primary care study.
  • Inclusion of 25,916 primary care patients.
  • Assessment of depressive episodes (ICD10) and dysthymia prevalence.

Main Results:

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  • High prevalence of depressive episodes (10.4%) and dysthymia (2.1%) was observed.
  • Only 54% of patients with psychological problems were recognized by GPs; specific depression diagnosis was only 15%.
  • Antidepressant prescription rates were 24% when identified as cases and 43% when identified as depressed.

Conclusions:

  • GPs under-recognize and under-diagnose depression in primary care.
  • Factors like reason for contact, patient demographics, severity, disability, and comorbidities influence recognition.
  • Treatment decisions, such as antidepressant prescription, appear influenced by factors beyond formal diagnosis.