Diagnosing depression in primary care: new approaches needed

ANN ARBOR—Researchers in the University of Michigan Health System say a new study illustrates the need for fresh approaches to defining and diagnosing depression by primary care doctors. The study “False Positives, False Negatives and the Validity of the Diagnosis of Major Depression in Primary Care” is published in the current edition of the Archives of Family Medicine.

The research team, led by Michael Klinkman, M.D., associate professor of family medicine, studied several hundred patients in southeast Michigan who were making visits to their family doctor. What emerged from the many findings is the idea that depression is a fluid disease that needs to be tracked over time to correctly diagnose and treat it in the primary care setting.

“We have not yet found the proper way to classify depressive disorders in primary care,” says Klinkman. “The boundaries between major depression and minor depression that have been so clearly defined in the psychiatric setting become blurred in primary care patients where symptoms change over time in response to many influences. Distress and depression might easily be detected during one office visit and totally hidden during another.”

Klinkman says the study had three major findings: