February Focus

摘要

As we begin to emerge from the peak period, at least in western cultures, for depressive illness, a number of authors in this month's Journal illuminate some important aspects of the recognition and management of this difficult problem. Mitchell and colleagues report the results of their European meta-analysis of diagnostic performance in primary care and identify international variation in ‘diagnostic sensitivity’, with Dutch primary care physicians apparently doing better than their counterparts in Australia and the US (page 110). The possible underlying explanations include differences in culture and in the organisation of health services between the countries – and the adoption of a structured system of follow-up in primary care emerges as an important variable. A particular problem, at least in the UK, in the detection of depression is identified by Harris and co-workers (page 135), who discovered that only one in five care home residents with diabetes or ischaemic heart disease had been screened for depression, compared with 66% of a comparable community sample.