Medical and psychosocial correlates of self-reported depressive symptoms in family practice.

A study was undertaken to examine the medical and psychosocial correlates of self-reported depressive symptoms in patients drawn from six community-based family practices. Of 293 adult patients approached in reception rooms, 262 between the ages of 17 and 70 years agreed to complete a brief screening instrument containing the Center for Epidemiologic Studies Depression Scale. Twenty-seven percent of these patients scored in the depressed range. The twofold excess of depressed women occurred at the point of seeking consultation rather than within the reception room sample. None of the depressed patients gave depression as their reason for visit. A weighted sample of 57 depressed and 39 nondepressed patients was selected for a telephone interview incorporating previously validated measures of physical health, life stress, and social support. Self-reported depression scores were associated with physical symptoms, chronic health problems, recent life events, and a lack of supportive relationships. Additionally, the association between physical symptoms and depression was not due to simple overlap between measures, and less severe interpersonal disturbance was a better predictor of depression than were traumatic life events. Additive combinations of stress, health, and support variables accounted for up to 30 percent of the variance in depression. Overall, the results highlight the difficulties facing family physicians attempting to detect depression among their patients.