Discovering Depression in Medical Patients: Reasonable Expectations
Authors: Kurt Kroenke
Journal: Annals of Internal Medicine (1997)

Editorials15 March 1997Discovering Depression in Medical Patients: Reasonable ExpectationsKurt Kroenke, MDKurt Kroenke, MDUniformed Services University of the Health Sciences, Bethesda, MD 20814Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-6-199703150-00008 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail One fact has been cited almost tiresomely: Primary care clinicians fail to diagnose depression in half of their patients who have the condition. When depression is detected, clinicians provide adequate treatment only half of the time [1-4]. Because 5% to 10% of medical outpatients (and even more inpatients) have major depression, this indictment is alarming. However, it is also a bit too facile. It ignores the barriers that make detection of depression particularly challenging in the medical setting: time, somatization, stigmatization, reimbursement, and comorbid medical conditions.Most medical outpatient visits last 15 minutes or less [5], whereas visits to a ...References1. Perez-Stable EJ, Miranda J, Munoz RF, Ying YW. Depression in medical outpatients. Underrecognition and misdiagnosis. Arch Intern Med. 1990; 150:1083-8. Google Scholar2. Simon GE, VonKorff M. Recognition, management, and outcomes of depression in primary care. Arch Fam Med. 1995; 4:99-105. Google Scholar3. Miranda J, Hohmann AA, Attkisson CC, Larson DB, eds. Mental Disorders in Primary Care. San Francisco: Jossey-Bass; 1994. Google Scholar4. Depression Guideline Panel. Depression in Primary Care. Clinical Practice Guideline, no 5. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; April 1993. AHCPR publication no. 93-0551. 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Google Scholar Author, Article, and Disclosure InformationAffiliations: Uniformed Services University of the Health Sciences, Bethesda, MD 20814Disclaimer: The opinions contained in this article are those of the author and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense.Corresponding Author: Kurt Kroenke, MD, Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRelation between Symptoms of Depression and Health Status Outcomes in Acutely Ill Hospitalized Older Persons Kenneth E. Covinsky , Richard H. Fortinsky , Robert M. Palmer , Denise M. Kresevic , and C. Seth Landefeld Association of Symptoms of Depression with Diagnostic Test Charges among Older Adults Christopher M. Callahan , Joseph G. Kesterson , and William M. 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A primer for employee benefit design, decision makers, and an outcome research example 15 March 1997Volume 126, Issue 6Page: 463-465KeywordsCancer treatmentDementiaDepressionElderlyFatigueGeriatric depressionInsomniaMyocardial infarctionOutpatientsPsychiatry and mental health Issue Published: 15 March 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...