Depression in Primary Care: Continuing Diagnostic Challenge and New Therapeutic Options

Most treatment for depression is delivered by primary care providers (PCPs). In two reports, researchers address concerns that depression is underdiagnosed and undertreated in this setting.

In a meta-analysis, researchers reviewed 41 studies involving more than 2000 PCPs in 10 countries, mostly in urban settings. Without use of structured diagnostic aids, the PCPs assessed the presence or absence of depression in more than 50,000 patients who underwent subsequent structured evaluations by mental health specialists to establish “true” diagnoses. The overall prevalence of true depression was 19.5%. After statistical adjustment, PCPs correctly identified 47.3% of patients with depression. In 19 studies in which researchers assessed PCPs' abilit…