Depression in primary care: Patient factors that influence recognition

Edward J Callahan, Klea D Bertakis, Rahman Azari, L. Jay Helms, John A Robbins, Jill Miller

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Background: Recognition of depression in primary care is both important and difficult. To study recognition of depression, we monitored care delivered to new adult patients randomly assigned to primary care providers. Methods: At study entry, 508 patients completed the Beck Depression Inventory (BDI) and the Medical Outcomes Study Short-form Health Survey-36 (SF-36), a measure of health status. Chart notes were reviewed at the end of 1 year. Results: Only 36 of 130 patients with elevated BDI scores ≤9 (moderate-to- severe depression) were noted as depressed on the chart. Patient characteristics predicting chart notation of depression included BDI scores, health status, gender, and education. When controlling for these factors, neither age nor race were statistically significant in the prediction of the recognition of depression. Female patients were more likely to be diagnosed as depressed than men with comparable BDI and SF-36 scores. Greater patient education was associated with enhanced likelihood of diagnosis of depression. Both BDI scores and health status were important predictors of diagnosis of depression. All SF-36 subscales correlated highly with BDI scores, suggesting that these measures may lack adequate discriminant validity. Conclusions: Identifying diagnostic tendencies may help primary care providers improve detection of depression, a critical first step toward effective management.

Original languageEnglish (US)
Pages (from-to)172-176
Number of pages5
JournalFamily Medicine
Issue number3
StatePublished - Mar 1997

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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