Depression in family practice: changes in pattern of patient visits and complaints during subsequent developing depressions.

This study was done to characterize changes in patient behavior during specific time periods immediately before first, second, third, and fourth episodes of depression. Forty-three patients from a group of 154 depressed patients examined in an earlier study developed 59 subsequent episodes of depression, and these were the patients used in this study. Suitable age and sex matched controls were also examined for the same time periods. The depressed patients and controls were patients in a rural solo practice. The depressed patients showed increased number of patient initiated visits, increased incidence of hospitalization, increased number of functional complaints, increased number of pain complaints, and increased feelings of tension as compared to controls during the seven months prior to the diagnosis date of the first and each succeeding episode of depression. The study results indicate that increased numbers of office visits, functional complaints, pain complaints, and anxiety complaints can be harbingers of a clinical depression, whether it be the index (first) or a subsequent depressive illness.