Skip to main content

Recognition of Depression by Non-psychiatric Physicians—A Systematic Literature Review and Meta-analysis

Journal of General Internal Medicine volume 23, pages 25–36 (2008)Cite this article

Abstract

BACKGROUND

Depression, with up to 11.9% prevalence in the general population, is a common disorder strongly associated with increased morbidity. The accuracy of non-psychiatric physicians in recognizing depression may influence the outcome of the illness, as unrecognized patients are not offered treatment for depression.

OBJECTIVES

To describe and quantitatively summarize the existing data on recognition of depression by non-psychiatric physicians.

METHODS

We searched the following databases: MEDLINE (1966–2005), Psych INFO (1967–2005) and CINAHL (1982–2005). To summarize data presented in the papers reviewed, we calculated the Summary receiver operating characteristic (ROC) and the summary sensitivity, specificity and odds ratios (ORs) of recognition, and their 95% confidence intervals using the random effects model.

MEASUREMENTS AND MAIN RESULTS

The summary sensitivity, specificity, and OR of recognition using the random effects model were: 36.4% (95% CI: 27.9–44.8), 83.7% (95% CI: 77.5–90.0), and 4.0 (95% CI: 3.2–4.9), respectively. We also calculated the Summary ROC. We performed a metaregression analysis, which showed that the method of documentation of recognition, the age of the sample, and the date of study publication have significant effect on the summary sensitivity and the odds of recognition, in the univariate model. Only the method of documentation had a significant effect on summary sensitivity, when the age of the sample and the date of publication were added to the model.

CONCLUSION

The accuracy of depression recognition by non-psychiatrist physicians is low. Further research should focus on developing standardized methods of documenting non-psychiatric physicians’ recognition of depression.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

Figure 1
Figure 2

References

  1. Berardi D, Menchetti M, De Ronchi RD, Rucci P, Leggieri G, Ferrari G. Late-life depression in primary care: a nationwide Italian epidemiological survey. J Am Geriatr Soc. 2002;50(1):77–83.

    PubMed  Article  Google Scholar 

  2. Murphy JM, Laird NM, Monson RR, Sobol AM, Leighton AH. A 40-year perspective on the prevalence of depression: the stirling county study. Arch Gen Psychiatry. 2000;57(3):209–15.

    PubMed  Article  CAS  Google Scholar 

  3. Wells KB, Sturm R, Sherbourne CD, Meredith LS. Caring for Depression. Cambridge, MA, US: Harvard University Press; 1996.

    Google Scholar 

  4. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause, 1990–2020: Global Burden of Disease Study. Lancet. 1997;349(9064):1498–504.

    PubMed  Article  CAS  Google Scholar 

  5. Jackson JL, Passamonti M, Kroenke K. Outcome and impact of mental disorders in primary care at 5 years. Psychosom Med. 2007;69(3):270–6.

    PubMed  Article  Google Scholar 

  6. Davidson JRT, Meltzer-Brody SE. The underrecognition and undertreatment of depression: what is the breadth and depth of the problem? J Clin Psychiatry. 1999;60(suppl. 7):4–11.

    PubMed  Google Scholar 

  7. Cole MG, Bellavance F. Depression in elderly medical inpatients: a meta-analysis of outcomes. Can Med Assoc J. 1997;157(8):1055–60.

    CAS  Google Scholar 

  8. Wittchen HU, Lieb R, Wunderlich U, Schuster P. Comorbidity in primary care: presentation and consequences. J Clin Psychiatry. 1999;60(suppl 7):29–36.

    PubMed  Google Scholar 

  9. Jackson JL, O’Malley PG, Kroenke K. Clinical predictors of mental disorders among medical outpatients. Validation of the “S4” model. Psychosomatics. 1998;39(5):431–6.

    PubMed  CAS  Google Scholar 

  10. O’Connor DW, Rosewarne R, Bruce A. Depression in primary care. 1: Elderly patients’ disclosure of depressive symptoms to their doctors. Int Psychogeriatr. 2001;13(3):359–65.

    PubMed  Article  CAS  Google Scholar 

  11. Herran A, Vazquez-Barquero JL, Dunn G. Recognition of depression and anxiety in primary care. Patients’ attributional style is important factor. BMJ. 1999;318(7197):1558.

    PubMed  CAS  Google Scholar 

  12. Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care. BMJ. 1999;318(7181):436–9.

    PubMed  CAS  Google Scholar 

  13. Docherty JP. Barriers to the diagnosis of depression in primary care. J Clin Psychiatry. 1997;58(suppl 1):5–10.

    PubMed  Google Scholar 

  14. Goldman LS, Nielsen NH, Champion HC. Awareness, diagnosis, and treatment of depression. J Gen Intern Med. 1999;14(9):569–80.

    PubMed  Article  CAS  Google Scholar 

  15. Wittchen HU, Pittrow D. Prevalence, recognition and management of depression in primary care in Germany: the Depression 2000 study. Human Psychopharmacol. 2002;17(suppl 1):1–11.

    Article  Google Scholar 

  16. Parchman ML. Physicians’ recognition of depression. Fam Pract Res J. 1992;12(4):431–8.

    PubMed  CAS  Google Scholar 

  17. Cooper LA, Brown C, Vu HT, Palenchar DR, Gonzales JJ, Ford DE, Powe NR. Primary care patients’ opinions regarding the importance of various aspects of care for depression. Gen Hosp Psychiatry. 2000;22(3):163–73.

    PubMed  Article  CAS  Google Scholar 

  18. Carney PA, Eliassen MS, Wolford GL, Owen M, Badger LW, Dietrich AJ. How physician communication influences recognition of depression in primary care. J Fam Pract. 1999;48(12):958–64.

    PubMed  CAS  Google Scholar 

  19. Kirmayer LJ. Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. [Review] [77 refs]. J Clin Psychiatry. 2001;62(suppl 13):22–8.

    PubMed  Google Scholar 

  20. McCall L, Clarke DM, Rowley G. A questionnaire to measure general practitioners’ attitudes to their role in the management of patients with depression and anxiety. Aust Fam Physician. 2002;31(3):299–303.

    PubMed  Google Scholar 

  21. Tai-Seale M, Bramson R, Drukker D, et al. Understanding primary care physicians’ propensity to assess elderly patients for depression using interaction and survey data. Med Care. 2005;43(12):1217–24.

    PubMed  Article  Google Scholar 

  22. Hedayati SS, Grambow SC, Szczech LA, Stechuchak KM, Allen AS, Bosworth HB. Physician-diagnosed depression as a correlate of hospitalizations in patients receiving long-term hemodialysis. Am J Kidney Dis. 2005;46(4):642–9.

    PubMed  Article  Google Scholar 

  23. Buist A, Bilszta J, Barnett B, et al. Recognition and management of perinatal depression in general practice—a survey of GPs and postnatal women. Aust Fam Physician. 2005;34(9):787–90.

    PubMed  Google Scholar 

  24. Richards HL, Fortune DG, Weidmann A, Sweeney SK, Griffiths CE. Detection of psychological distress in patients with psoriasis: low consensus between dermatologist and patient. Br J Dermatol. 2004;151(6):1227–33.

    PubMed  Article  CAS  Google Scholar 

  25. Furedi J, Rozsa S, Zambori J, Szadoczky E. The role of symptoms in the recognition of mental health disorders in primary care. Psychosomatics 2003;44(5):402–6.

    PubMed  Article  Google Scholar 

  26. Evers MM, Samuels SC, Lantz M, Khan K, Brickman AM, Marin DB. The prevalence, diagnosis and treatment of depression in dementia patients in chronic care facilities in the last six months of life. Int J Geriatr Psychiatry. 2002;17(5):464–72.

    PubMed  Article  Google Scholar 

  27. Harman JS, Schulberg HC, Mulsant BH, Reynolds CF, III. The effect of patient and visit characteristics on diagnosis of depression in primary care. J Fam Pract. 2001;50(12):1068.

    PubMed  CAS  Google Scholar 

  28. Luber MP, Hollenberg JP, Williams-Russo P, et al. Diagnosis, treatment, comorbidity, and resource utilization of depressed patients in a general medical practice. Int J Psychiatry Med. 2000;30(1):1–13.

    PubMed  Article  CAS  Google Scholar 

  29. Lecrubier Y. Is depression under-recognised and undertreated? Int Clin Psychopharmacol. 1998;13(suppl. 5):S3–S6.

    PubMed  Article  Google Scholar 

  30. Schmidt LA, Greenberg BD, Holzman GB, Schulkin J. Treatment of depression by obstetrician-gynecologists: a survey study. Obstet Gynecol. 1997;90(2):296–300.

    PubMed  Article  CAS  Google Scholar 

  31. Strothers HS III, Rust G, Minor P, Fresh E, Druss B, Satcher D. Disparities in antidepressant treatment in Medicaid elderly diagnosed with depression. J Am Geriatr Soc. 2005;53(3):456–61.

    PubMed  Article  Google Scholar 

  32. Rout U, Rout J. Diagnosis and treatment of depression by general practitioners in England. Psychol Rep. 1996;78(2):516–8.

    PubMed  CAS  Google Scholar 

  33. Crystal S, Sambamoorthi U, Walkup JT, Akincigil A. Diagnosis and treatment of depression in the elderly medicare population: predictors, disparities, and trends. J Am Geriatr Soc. 2003;51(12):1718–28.

    PubMed  Article  Google Scholar 

  34. Webber AP, Martin JL, Harker JO, Josephson KR, Rubenstein LZ, Alessi CA. Depression in older patients admitted for postacute nursing home rehabilitation. J Am Geriatr Soc. 2005;53(6):1017–22.

    PubMed  Article  Google Scholar 

  35. Eisses A-M, Kluiter H, Jongenelis K, Pot AM, Beekman ATF, Ormel J. Care staff training in detection of depression in residential homes for the elderly: randomised trial. Br J Psychiatry. 2005;186:404–9.

    PubMed  Article  CAS  Google Scholar 

  36. Preville M, Cote G, Boyer R, Hebert R. Detection of depression and anxiety disorders by home care nurses. Aging Ment Health. 2004;8(5):400–9.

    PubMed  Article  CAS  Google Scholar 

  37. Brown EL, Bruce ML, McAvay GJ, Raue PJ, Lachs MS, Nassisi P. Recognition of late-life depression in home care: accuracy of the outcome and assessment information set. J Am Geriatr Soc. 2004;52(6):995–9.

    PubMed  Article  Google Scholar 

  38. Dobalian A, Tsao JCI, Radcliff TA. Diagnosed mental and physical health conditions in the United States nursing home population: differences between urban and rural facilities. J Rural Health. 2003;19(4):477–83.

    PubMed  Article  Google Scholar 

  39. Barton C, Miller B, Yaffe K. Evaluation of the diagnosis and management of cognitive impairment in long-term care. Alzheimer Dis Assoc Disord. 2003;17(2):72–6.

    PubMed  Article  Google Scholar 

  40. Leo RJ, Sherry C, Jones AW. Referral patterns and recognition of depression among African-American and Caucasian patients. Gen Hosp Psych. 1998;20(3):175–82.

    Article  CAS  Google Scholar 

  41. Teresi JA, Abrams R, Holmes D, Ramirez M, Shapiro C, Eimicke JP. Influence of cognitive impairment, illness, gender, and African-American status on psychiatric ratings and staff recognition of depression. Am J Geriatr Psychiatry. 2002;10(5):506–14.

    PubMed  Article  Google Scholar 

  42. Watts SC, Bhutani GE, Stout IH, et al. Mental health in older adult recipients of primary care services: is depression the key issue? Identification, treatment and the general practitioner. Int J Geriatr Psychiatry. 2002;17(5):427–37.

    PubMed  Article  CAS  Google Scholar 

  43. Teresi J, Abrams R, Holmes D, Ramirez M, Eimicke J. Prevalence of depression and depression recognition in nursing homes. Soc Psychiatry Psychiatr Epidemiol. 2001;36(12):613–20.

    PubMed  Article  CAS  Google Scholar 

  44. Rincon HG, Granados M, Unutzer J, et al. Prevalence, detection and treatment of anxiety, depression, and delirium in the adult critical care unit. Psychosomatics. 2001;42(5):391–6.

    PubMed  Article  CAS  Google Scholar 

  45. Bagley H, Cordingley L, Burns A, et al. Recognition of depression by staff in nursing and residential homes. J Clin Nurs. 2000;9(3):445–50.

    PubMed  Article  CAS  Google Scholar 

  46. McDonald MV, Passik SD, Dugan W, Rosenfeld B, Theobald DE, Edgerton S. Nurses’ recognition of depression in their patients with cancer. Oncol Nurs Forum. 1999;26(3):593–9.

    PubMed  CAS  Google Scholar 

  47. Shah A, De T. Documented evidence of depression in medical and nursing case-notes and its implications in acutely ill geriatric inpatients. Int Psychogeriatr 1998;10(2):163–72.

    PubMed  Article  CAS  Google Scholar 

  48. Boyle VL, Roychoudhury C, Beniak R, Cohn L, Bayer A, Katz I. Recognition and management of depression in skilled-nursing and long-term care settings: evolving targets for quality improvement. Am J Geriatr Psychiatry. 2004;12(3):288–95.

    PubMed  Article  Google Scholar 

  49. Bell M, Goss AJ. Recognition, assessment and treatment of depression in geriatric nursing home residents. Clin Excell Nurse Pract 2001;5(1):26–36.

    PubMed  CAS  Google Scholar 

  50. Halloran E, Prentice N, Murray CL, et al. Follow-up study of depression in the elderly. Clinical and SPECT data. Br J Psychiatry. 1999;175:252–8.

    PubMed  CAS  Google Scholar 

  51. Boey KW. Detection of geriatric depression: knowledge and practice of hospital nurses. Clin Gerontol. 1999;20(2):47–56.

    Article  Google Scholar 

  52. Sullivan K, Dyck J, Culp KR, Buckwalter K. Comparing the geriatric depression scale, minimum data set, and primary care provider diagnosis for depression in rural nursing home residents. J Am Psychiatr Nurses Assoc. 2005;11(5):270–75.

    Google Scholar 

  53. Brown EL, McAvay G, Raue PJ, Moses S, Bruce ML. Recognition of depression among elderly recipients of home care services. Psychiatr Serv. 2003;54(2):208–13.

    PubMed  Article  Google Scholar 

  54. Koenig HG, Goli V, Shelp F, Kudler HS, Cohen HJ, Blazer DG. Major depression in hospitalized medically ill older men: documentation, management, and outcome. Int J Geriatr Psychiatry. 1992;7(1):25–34.

    Article  Google Scholar 

  55. Bowler C, Boyle A, Branford M, Cooper S-A, Harper R, Lindesay J. Detection of psychiatric disorders in elderly medical inpatients. Age Ageing. 1994;23(4):307–11.

    PubMed  Article  CAS  Google Scholar 

  56. Huffman JC, Smith FA, Blais MA, Beiser ME, Januzzi JL, Fricchione GL. Recognition and Treatment of Depression and Anxiety in Patients With Acute Myocardial Infarction. Am J Cardiol. 2006;98(3):319–24.

    PubMed  Article  Google Scholar 

  57. Helmes E, Duggan GM. Assessment of depression in older adult males by general practitioners. Ageism, physical problems and treatment. [see comment]. Aust Fam Phys. 2001;30(3):291–4.

    CAS  Google Scholar 

  58. Tylee A, Freeling P, Kerry S, Burns T. How does the content of consultations affect the recognition by general practitioners of major depression in women? Br J Gen Pract. 1995;45(400):575–8.

    PubMed  CAS  Google Scholar 

  59. Passik SD, Donaghy KB, Theobald DE, Lundberg JC, Holtsclaw E, Dugan J. Oncology staff recognition of depressive symptoms on videotaped interviews of depressed cancer patients: implications for designing a training program. Journal of Pain and Symptom Management. 2000;19(5):329–38.

    PubMed  Article  CAS  Google Scholar 

  60. Stoppe G, Sandholzer H, Huppertz C, Duwe H, Staedt J. Family physicians and the risk of suicide in the depressed elderly. J Affect Disord. 1999;54(1–2):193–8.

    PubMed  Article  CAS  Google Scholar 

  61. Penn JV, Boland R, McCartney JR, Kohn R, Mulvey T. Recognition and treatment of depressive disorders by internal medicine attendings and housestaff. Gen Hosp Psychiatry. 1997;19(3):179–84.

    PubMed  Article  CAS  Google Scholar 

  62. Hasin D, Link B. Age and recognition of depression: implications for a cohort effect in major depression. Psychol Med. 1988;18(3):683–8.

    PubMed  CAS  Google Scholar 

  63. Gerrity MS, Cole SA, Dietrich AJ, Barrett JE. Improving the recognition and management of depression: is there a role for physician education? J Fam Pract. 1999;48(12):949–57.

    PubMed  CAS  Google Scholar 

  64. Dowrick C, Buchan I. Twelve month outcome of depression in general practice: does detection or disclosure make a difference? Br Med J. 1995;311(7015):1274–6.

    CAS  Google Scholar 

  65. Gallo JJ, Bogner HR, Straton JB, et al. Patient characteristics associated with participation in a practice-based study of depression in late life: the spectrum study. Int J Psychiatry Med. 2005;35(1):41–57.

    PubMed  Article  Google Scholar 

  66. Bellantuono C, Mazzi MA, Tansella M, Rizzo R, Goldberg D. The identification of depression and the coverage of antidepressant drug prescriptions in Italian general practice. J Affect Disord. 2002;72(1):53–9.

    PubMed  Article  Google Scholar 

  67. Bogner HR, Ford DE, Gallo JJ. The role of cardiovascular disease in the identification and management of depression by primary care physicians. Am J Geriatr Psychiatry. 2006;14(1):71–8.

    PubMed  Article  Google Scholar 

  68. Weintraub D, Moberg PJ, Duda JE, Katz IR, Stern MB. Recognition and treatment of depression in Parkinson’s disease. J Geriatr Psychiatry Neurol. 2003;16(3):178–83.

    PubMed  Article  Google Scholar 

  69. Deeks JJ. Systematic reviews in health care: systematic reviews of evaluations of diagnostic and screening tests. BMJ. 2001;323(7305):157–62.

    PubMed  Article  CAS  Google Scholar 

  70. Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S. Oncologists’ recognition of depression in their patients with cancer. J Clin Oncol. 1998;16(4):1594–600.

    PubMed  CAS  Google Scholar 

  71. Schulman E, Gairola G, Kuder L, McCulloch J. Depression and associated characteristics among community-based elderly people. J Allied Health. 2002;31(3):140–6.

    PubMed  Google Scholar 

  72. Berardi D, Menchetti M, Cevenini N, Scaini S, Versari M, De RD. Increased recognition of depression in primary care: comparison between primary-care physician and ICD-10 diagnosis of depression. Psychother Psychosom. 2005;74(4):225–30.

    PubMed  Article  Google Scholar 

  73. Bertakis KD, Helms LJ, Callahan EJ, Azari R, Leigh P, Robbins JA. Patient gender differences in the diagnosis of depression in primary care. J Women’s Health Gend-Based Med. 2001;10(7):689–98.

    Article  CAS  Google Scholar 

  74. Volkers AC, Nuyen J, Verhaak PFM, Schellevis FG. The problem of diagnosing major depression in elderly primary care patients. J Affect Disord. 2004;82(2):259–63.

    PubMed  Article  Google Scholar 

  75. Bowers J, Jorm AF, Henderson S, Harris P. General practitioners’ detection of depression and dementia in elderly patients. Med J Aust. 1990;153(4):192–6.

    PubMed  CAS  Google Scholar 

  76. Crawford MJ, Prince M, Menezes P, Mann AH. The recognition and treatment of depression in older people in primary care. Int J Geriatr Psychiatry. 1998;13(3):172–6.

    PubMed  Article  CAS  Google Scholar 

  77. Klinkman MS, Coyne JC, Gallo S, Schwenk TL. False positives, false negatives, and the validity of the diagnosis of major depression in primary care. Arch Fam Med. 1998;7(5):451–61.

    PubMed  Article  CAS  Google Scholar 

  78. Nuyen J, Volkers AC, Verhaak PFM, Schellevis FG, Groenewegen PP, Van den Bos GAM. Accuracy of diagnosing depression in primary care: the impact of chronic somatic and psychiatric co-morbidity. Psychol Med. 2005;35(8):1185–95.

    PubMed  Article  Google Scholar 

  79. Simon GE, Goldberg SD, Tiemens BG, Ustun TB. Outcomes of recognized and unrecognized depression in an international primary care study. Gen Hosp Psychiatry. 1999;21(2):97–105.

    PubMed  Article  CAS  Google Scholar 

  80. Wittchen H-U, Hofler M, Meister W. Prevalence and recognition of depressive syndromes in German primary care settings: poorly recognized and treated? Int Clin Psychopharmacol. 2001;16(3):121–35.

    Article  CAS  Google Scholar 

  81. Goehring C, Perrier A, Morabia A. Spectrum bias: a quantitative and graphical analysis of the variability of medical diagnostic test performance. Stat Med. 2004;23(1):125–35.

    PubMed  Article  Google Scholar 

  82. Ransohoff DF, Feinstein AR. Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. N Engl J Med. 1978;299(17):926–30.

    PubMed  CAS  Article  Google Scholar 

  83. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.

    PubMed  Article  CAS  Google Scholar 

  84. Moses LE, Shapiro D, Littenberg B. Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med. 1993;12(14):1293–316.

    PubMed  Article  CAS  Google Scholar 

  85. Cooper H, Hedges LV. The Handbook of Research Synthesis. New York, NY, US: Russell Sage Foundation; 1994.

    Google Scholar 

  86. Asch SM, Kilbourne AM, Gifford AL, et al. Underdiagnosis of depression in HIV: who are we missing? J Gen Intern Med. 2003;18(6):450–60.

    PubMed  Article  Google Scholar 

  87. Balestrieri M, Bisoffi G, Tansella M, Martucci M, Goldberg DP. Identification of depression by medical and surgical general hospital physicians. Gen Hosp Psychiatry. 2002;24(1):4–11.

    PubMed  Article  Google Scholar 

  88. Callahan EJ, Bertakis KD, Azari R, Helms LJ, Robbins J, Miller J. Depression in primary care: patient factors that influence recognition. Fam Med. 1997;29(3):172–6.

    PubMed  CAS  Google Scholar 

  89. Garrard J, Rolnick SJ, Nitz NM, et al. Clinical detection of depression among community-based elderly people with self-reported symptoms of depression. J Gerontol Ser A Biol Sci Med Sci. 1998;53(2):M92–M101.

    CAS  Google Scholar 

  90. Lichtenberg PA, Gibbons TA, Nanna M, Blumenthal F. Physician detection of depression in medically ill elderly. Clin Gerontol. 1993;13(1):81–90.

    Article  Google Scholar 

  91. Perez-Stable EJ, Miranda J, Munoz RF, Ying Y-W. Depression in medical outpatients. Underrecognition and misdiagnosis. Arch Intern Med 1990;150(5):1083–8.

    PubMed  Article  CAS  Google Scholar 

  92. Pouget R, Yersin B, Wietlisbach V, Burnand B, Bula CJ. Depressed mood in a cohort of elderly medical inpatients: Prevalence, clinical correlates and recognition rate. Aging Clin Exp Res. 2000;12(4):301–7.

    CAS  Google Scholar 

  93. Rapp SR, Walsh DA, Parisi SA, Wallace CE. Detecting depression in elderly medical inpatients. J Consult Clin Psychol. 1988;56(4):509–13.

    PubMed  Article  CAS  Google Scholar 

  94. Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression: two questions are as good as many. J Gen Int Med. 1997;12(7):439–45.

    Article  CAS  Google Scholar 

  95. Zung WWK, Magill M, Moore JT, George DT. Recognition and treatment of depression in a family medicine practice. J Clin Psychiatry. 1983;44(1):3–6.

    PubMed  CAS  Google Scholar 

  96. Aragones E, Pinol JL, Labad A, Folch S, Melich N. Detection and management of depressive disorders in primary care in Spain. Int J Psychiatry Med. 2004;34(4):331–43.

    PubMed  Article  Google Scholar 

  97. Coyne JC, Schwenk TL, Fechner-Bates S. Nondetection of depression by primary care physicians reconsidered. Gen Hosp Psychiatry. 1995;17(1):3–12.

    PubMed  Article  CAS  Google Scholar 

  98. Katon WJ, Simon G, Russo J, et al. Quality of depression care in a population-based sample of patients with diabetes and major depression. Med Care. 2004;42(12):1222–9.

    PubMed  Article  Google Scholar 

  99. Pfaff JJ, Almeida OP. A cross-sectional analysis of factors that influence the detection of depression in older primary care patients. Aust N Z J Psychiatry. 2005;39(4):262–5.

    PubMed  Article  Google Scholar 

  100. Pond CD, Mant A, Bridges-Webb C, et al. Recognition of depression in the elderly: a comparison of general practitioner opinions and the geriatric depression scale. Fam Pract 1990;7(3):190–4.

    PubMed  Article  CAS  Google Scholar 

  101. Shulman LM, Taback RL, Rabinstein AA, Weiner WJ. Non-recognition of depression and other non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord 2002;8(3):193–7.

    PubMed  Article  CAS  Google Scholar 

  102. Stek ML, Gussekloo J, Beekman ATF, Van TW, Westendorp RGJ. Prevalence, correlates and recognition of depression in the oldest old: The Leiden 85-plus study. J Affect Disord. 2004;78(3):193–200.

    PubMed  Article  CAS  Google Scholar 

  103. McCusker J, Karp E, Yaffe MJ, Cole M, Bellavance F. Determining detection of depression in the elderly by primary care physicians: chart review or questionnaire? Prim Care Psychiatry. 1996;2(4):217–21.

    Google Scholar 

  104. Meldon SW, Emerman CL, Schubert DSP. Recognition of depression in geriatric ED patients by emergency physicians. Ann Emerg Med. 1997;30(4):442–7.

    PubMed  Article  CAS  Google Scholar 

  105. Meldon SW, Emerman CL, Schubert DSP, Moffa DA, Etheart RG. Depression in geriatric ED patients: prevalence and recognition. Ann Emerg Med. 1997;30(2):141–5.

    PubMed  Article  CAS  Google Scholar 

  106. Sliman RJ, Donohue TA, Jarjoura D, Ognibene AJ. Recognition of depression by internal medicine residents. J Commun Health. 1992;17(3):143–52.

    Article  CAS  Google Scholar 

  107. Thompson C, Ostler K, Peveler RC, Baker N, Kinmonth A. Dimensional perspective on the recognition of depressive symptoms in primary care: the Hampshire depression project 3. Br J Psychiatry. 2001;179:317–23.

    PubMed  Article  CAS  Google Scholar 

  108. Christensen KS, Toft T, Frostholm L, Ornbol E, Fink P, Olesen F. The FIP Study: a randomised, controlled trial of screening and recognition of psychiatric disorders. Br J Gen Pract. 2003;53(495):758–63.

    PubMed  Google Scholar 

  109. Balestrieri M, Carta MG, Leonetti S, Sebastiani G, Starace F, Bellantuono C. Recognition of depression and appropriateness of antidepressant treatment in Italian primary care. Soc Psychiatry Psychiatr Epidemiol. 2004;39(3):171–6.

    PubMed  Article  Google Scholar 

  110. Becker SM. Detection of somatization and depression in primary care in Saudi Arabia. Soc Psychiatry Psychiatr Epidemiol. 2004;39(12):962–6.

    PubMed  Article  Google Scholar 

  111. Spitzer RL, Forman JB, Nee J. DSM-III field trials: I. Initial interrater diagnostic reliability. Am J Psych 1979;136(6):815–7.

    CAS  Google Scholar 

  112. Borowsky SJ, Rubenstein LV, Meredith LS, Camp P, Jackson-Triche M, Wells KB. Who is at risk of nondetection of mental health problems in primary care? J Gen Intern Med. 2000;15(6):381–8.

    PubMed  Article  CAS  Google Scholar 

  113. Barrett JE, Williams JW Jr, Oxman TE, et al. Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract. 2001;50(5):405–12.

    PubMed  CAS  Google Scholar 

  114. Ronalds C, Creed F, Stone K, Webb S, Tomenson B. Outcome of anxiety and depressive disorders in primary care. Br J Psychiatry. 1997;171:427–33.

    PubMed  CAS  Article  Google Scholar 

  115. Pini S, Berardi D, Rucci P, et al. Identification of psychiatric distress by primary care physicians. Gen Hosp Psych. 1997;(6):411–8.

  116. Tiemens BG, Vonkorff M, Lin EHB. Diagnosis of depression by primary care physicians versus a structured diagnostic interview: understanding discordance. Gen Hosp Psych. 1999;21(2): 87–96.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by a grant from Fonds de la recherche en santé du Québec (Grant number 25004-2560) and two grants from Institutes for Health Research (Grant numbers MOP-64462 and 11949).

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Department of Clinical Epidemiology and Community Studies, St. Mary’s Hospital, Montreal, QC, Canada

    Monica Cepoiu MD, MSc, Jane McCusker MD, DrPH, Maida Sewitch PhD, Eric Belzile MSc & Antonio Ciampi PhD

  2. Department of Community Health Studies, University of Calgary, Calgary, AB, Canada

    Monica Cepoiu MD, MSc

  3. Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada

    Jane McCusker MD, DrPH & Antonio Ciampi PhD

  4. Department of Psychiatry, St. Mary’s Hospital, Montreal, Canada

    Martin G. Cole MD, FRCP(C)

  5. Department of Psychiatry, McGill University, Montreal, Canada

    Martin G. Cole MD, FRCP(C)

  6. Department of Medicine, McGill University, Montreal, QC, Canada

    Maida Sewitch PhD

Authors
  1. Monica Cepoiu MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jane McCusker MD, DrPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Martin G. Cole MD, FRCP(C)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maida Sewitch PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eric Belzile MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonio Ciampi PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monica Cepoiu MD, MSc.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Cepoiu, M., McCusker, J., Cole, M.G. et al. Recognition of Depression by Non-psychiatric Physicians—A Systematic Literature Review and Meta-analysis. J GEN INTERN MED 23, 25–36 (2008). https://doi.org/10.1007/s11606-007-0428-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-007-0428-5

KEY WORDS

  • recognition
  • depression
  • meta-analysis