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Interventions Needed To Target Depression In Special Groups
A DGReview of :"The Effect of Patient and Visit Characteristics on Diagnosis of Depression in Primary Care"
Journal of Family Practice
12/13/2001
By Elda Hauschildt
Interventions targeted to special groups are needed to help doctors recognise depression in African-American and older patients.
Patients in both groups have low rates of depressive diagnoses in primary care, United States researchers say.
"This is a particularly high priority since both African-Americans and elderly patients are more likely to seek treatment in the primary care sector rather than the mental health specialty sector," say investigators from the University of Pittsburgh in Pennsylvania and Cornell University in Ithaca, New York.
"Feedback about differences in age- and race-specific (diagnostic) rates could possibly provide the impetus needed for primary-care doctors to alter their assessment procedures and clinical formulations in these under-recognised groups of patients.
"Intervention efforts may want to focus on the unique manner in which internists formulate psychiatric diagnoses, since recognition rates for depression are unduly low in this specialty group," the researchers add.
They used data from the 1997 and 1998 US National Ambulatory Medical Care Surveys to assess the association of age, race, doctor specialty, type of insurance and visit duration with a depression diagnosis recorded during visits to primary-care doctors.
"After controlling for symptom presentation, primary-care physicians were 56 percent less likely to record a diagnosis of depression during visits made by elderly patients," investigators say.
Primary-care doctors were also 37 percent less likely to identify African-Americans as depressed and 35 percent less likely to diagnose patients on public health insurance.
"Visits with a depression diagnosis were on average 2.9 minutes longer in duration than visits without a depression diagnosis.
"Family practice and general-practice physicians were 65 percent more likely to record a diagnosis of depression than internists."
Journal of Family Practice, 2001; Vol. 50, No. 12.
"The Effect of Patient and Visit Characteristics on Diagnosis of Depression in Primary Care"
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