Depression in adults: GPs are not so bad at diagnosis

Kendrick, T. (2008) Depression in adults: GPs are not so bad at diagnosis. British Medical Journal, 336, (7643), 522. (doi:10.1136/bmj.39507.524711.80).


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Timonen and Liukkonen state that, according to cross sectional studies, 50-70% of patients with depression in primary care remain undetected.1 This attack on GPs’ ability to recognise depression is out of date and should not go unchallenged.

Studies have shown that many missed cases have relatively mild symptoms, that lie just above the threshold on screening measures for depression. These cases have dubious clinical relevance and may be false positives because all diagnostic measures have rating errors.2 In addition, cross sectional recognition rates are obtained from a single 10 minute consultation and usually exclude patients whom GPs have already recognised as depressed.

The article fails to acknowledge studies showing that many "missed" patients are diagnosed correctly at later visits. Kessler et al found that, although many patients with depression did not receive a diagnosis at a single consultation, most were given one at later consultations or recovered without a GP’s.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1136/bmj.39507.524711.80
ISSNs: 0959-8138 (print)
Related URLs:
Keywords: humans, gps, letter, standards, depression, family practice, diagnosis, adults, clinical competence, depressive disorder, adult
Divisions : University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
ePrint ID: 61883
Accepted Date and Publication Date:
Date Deposited: 03 Sep 2008
Last Modified: 31 Mar 2016 12:45

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