Impact of Depressive Symptoms on Process of Primary Care. Abstract, ExecutiveSummary and Final Report

摘要

Depression is common and debilitating in primary care, often presenting throughsomatic symptoms, with poor recognition and treatment. Depressive symptoms may influence process and outcome of care. New patients (N=508) were randomly assigned to family practice and internal medicine physicans for one year. Seventy-seven (15%) were identified as depressed on charts, while 130 (26%) had a Beck Depression Inventory (BDI) score equal to or greater than 9. Both presence of depressive symptoms and physician recognition of depression altered the phyician patient interaction on the time spent counseling, chatting, taking history, and conducting physical examinations and preventive services. Patient characteristics predicitng chart notation of depression included BDI scores, health status, gender, and education. Patients with elevated BDI scores at entry showed significant improvement at study exit, regardless of whether the physician recognized depression. However, those recognized as depressed had significantly higher initial BDI scores. Those diagnosed with depression had more primary care clinic visits and laboratory and diagnostics tests, as well as higher total medical charges.