The effect of screening, sensitization, and feedback on notation of depression.

Medical records of 150 medical ambulatory care patients randomly assigned to groups in which screening for depression, physician sensitization about depression, and informational feedback to physicians were systemically varied were reviewed for physician notations about depression and its treatment. Forty-two percent of the 100 patients screened with the Zung self-rating depression scale had scores outside the normal range. Chart notation about depression was effectively and appropriately increased by feedback and sensitization from 8 to 25 percent, but these procedures were less effective in increasing treatment interventions, which were noted for 12 percent of the entire sample. Physicians responded to patient information about depression presented to them in the format of a laboratory test, and such previsit screening devices may increase physician attention to psychological problems in general medical settings.