Understanding Depression Diagnosis in Primary Care
Author Information
Author(s): Ani Chizobam, Bazargan Mohsen, Hindman David, Bell Douglas, Farooq Muhammad A, Akhanjee Lutful, Yemofio Francis, Baker Richard, Rodriguez Michael
Primary Institution: Charles R Drew University of Medicine and Science
Hypothesis
Is there a discordance between patients' self-reported depression symptoms and physicians' documentation of these symptoms in primary care settings?
Conclusion
Two-thirds of individuals with depression are undiagnosed in primary care settings, highlighting the need for better screening practices.
Supporting Evidence
- 75.3% of participants screened positive for depression.
- Only 31.0% of those diagnosed with depression by physicians.
- 57.6% of participants with significant depression symptoms also had functional impairment.
- The agreement between self-reported symptoms and physician documentation was very low.
Takeaway
Many people with depression don't get diagnosed by their doctors because they don't talk about their feelings, and doctors might not ask the right questions.
Methodology
Interviewer administered surveys and medical record reviews were conducted over a year with patients screened for depression.
Potential Biases
Patients may not disclose symptoms due to fear of stigma, affecting the accuracy of physician documentation.
Limitations
The study may not represent all physician practices and relies on medical record reviews, which could reflect documentation practices rather than actual knowledge.
Participant Demographics
Mean age of participants was 50.26 years; 62.8% Latino, 24.7% African American, and 48.4% uninsured.
Statistical Information
P-Value
p<0.05 for insomnia or hypersomnia and p<0.01 for suicidal ideation.
Confidence Interval
95% CI for suicidal ideation: [2.06–14.49]; for insomnia: [1.09–3.75]
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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