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J Fam Pract. 2001 Dec;50(12):1068.

The effect of patient and visit characteristics on diagnosis of depression in primary care.

Author information

  • 1Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara St, Suite 430, Pittsburgh, PA, 15213, USA. harmanjs@msx.upmc.edu.

Abstract

OBJECTIVES:

The purpose of our study was to determine if factors other than the patient' clinical presentation were associated with the likelihood of depression being recognized during a physician office visit.

STUDY DESIGN:

We used a cross-sectional design.

POPULATION:

Data from the 1997 and 1998 National Ambulatory Medical Care Surveys were examined.

OUTCOMES MEASURED:

We assessed the association of factors such as age, sex, race, physician specialty, type of insurance, and visit duration with a recorded depression diagnosis during office visits to primary care physicians.

RESULTS:

After controlling for symptom presentation, primary care physicians were 56% less likely to record a diagnosis of depression during visits made by elderly patients, 37% less likely to do so during visits by African Americans, and 35% less likely to do so during visits by Medicaid patients. Visits with a depression diagnosis were, on average, 2.9 minutes longer in duration (16.4 vs 19.3) than visits without a depression diagnosis. Family practice and general practice physicians were 65% more likely to record a diagnosis of depression than internists.

CONCLUSIONS:

Many factors were associated with making and recording a depression diagnosis beyond the patient' reported symptoms. If rates of diagnosis are to improve, interventions that go beyond getting physicians to recognize the symptoms of depression are needed.

PMID:
11742610
[PubMed - indexed for MEDLINE]
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