Prevalence and diagnosis of depression in family medicine

Abstract

Objectives: To obtain an estimate of the prevalence of depressive disorders amongst patients between the ages of 35 and 65 who make use of the primary health services; study the validity of the Portuguese version of the CES-D (Center for Epidemiologic Studies Depression Scale); study the factors that may make the diagnosis difficult for the general practitioner. Type of Study: Descriptive, cross-sectional. Site: Cascais Health Center. Population: Patients with 35 - 65 years of age who make use of the doctor´s appointments. Methods: A sample of 260 patients within the established age group, who had been to an appointment in the Health Centre, was collected. For each case, the general practitioner indicated the active health problems. Following this, each one of the patients answered the depression scale, and, those who accepted (N=179), participated in a structured interview in order to evaluate the possible presence of a depressive disorder according to the criteria of the DSM-IV. Results: It was verified that 13% of the patients suffered from a Major Depressive Episode and, globally, 33% presented some form of depressive disorder. The general practitioner indicated the presence of depressive problems only in 36% of these cases (or 46% of those who met the criteria for a Major Depressive Episode). The fact that the subjects presented other health problems and did not spontaneously present complaints of a depressive nature seems to be the factor that contributes most to the difficulty in diagnosis.