Prevalence and recognition of depression among primary care outpatients.

Studies indicate that more individuals suffering from depressive symptoms will present to the primary care outpatient clinic than to any other medical care setting. Unfortunately, most of these patients complain of somatic problems, not mood disturbances. Consequently, less than one half of all depressed patients in the primary care clinic are initially identified and treated for their depression. As depression causes considerable morbidity and some mortality and is treatable, methods of improving recognition should be sought. Some of these include maintaining a high index of suspicion, conducting a brief but thorough screening interview for depression, and using a depression rating scale. Benefits derived from early recognition include saving time, effort, and money spent on unnecessary tests and inappropriate treatment, and avoiding substantial suffering. The threshold for many somatic complaints can be substantially raised with resolution of depression.