Abstract
In an effort to elucidate the process of internists’ recognition of depression in primary care settings, a comparison of internist and “gold standard” psychiatric assessments of patients was undertaken in a rural primary care practice over a 15-month period. Clinical characteristics and diagnoses, global assessments of psychosocial stress, and two aspects of chief-complaint presentation style, clarity and somatization, were recorded by the internists for each patient, who was independently assessed by a psychiatrist for the presence of any specific depressive disorder by structured interview. Internists correctly labeled 57% of the interview-assessed depressives as depressed; 13% of patients with “no psychiatric disorder” were assessed as depressed by internists. Clinical and demographic characteristics of the “false-negative” and “false-positive” internists’ diagnoses were examined to clarify how internists think of “depression” in the primary care context.
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Received from the Division of General Internal Medicine, Department of Medicine, Dartmouth Medical School, and the Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire.
Supported by NIMH Grant No. MH-3752.
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Gerber, P.D., Barrett, J., Barrett, J. et al. Recognition of depression by internists in primary care. J Gen Intern Med 4, 7–13 (1989). https://doi.org/10.1007/BF02596483
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DOI: https://doi.org/10.1007/BF02596483