Undetected depression in primary healthcare: occurrence, severity and co-morbidity in a two-stage procedure of opportunistic screening
Abstract
Louise Lotfia, Lena Flyckt*b, Ingvar Krakaua, Björn Mårtenssonb & Gunnar H. Nilssonaa Department of Neurobiology, Care Science and Society, Centre for Family and Community Medicine, Karolinska Institutet, Stockholm, Swedenb Department of Clinical Neurosciences, Division of Psychiatry, Karolinska Institutet, Stockholm, SwedenLena Flyckt, Research and Development section, Northern Stockholm Psychiatry, 11281 Stockholm, Sweden. E-mail: lena.flyckt@sll.seBackground: Depression often remains undetected in primary healthcare, and a two-stage screening procedure has been recommended for future research on the recognition, management and outcome of these patients. The aim of this study was to analyse the occurrence and the severity of depression, as well as gender, age and psychiatric co-morbidity in patients with previously undetected depression using a screening questionnaire followed by a diagnostic interview for detecting depression among patients visiting primary healthcare. Methods: All patients visiting a primary healthcare centre during a period of 10 days were asked to fill in the self-rating version of the Montgomery–Åsberg Depression Rating Scale. Patients with a score of 12 or more were invited to participate in a structured diagnostic interview based on the Primary Care Evaluation of Mental Disorders. Results: Out of 221 (=N) participants, 45 (20.4%) patients showed signs of depression (scores of 12 or more). Of these 45 patients, 31 consented to the structured interview, and of those, 28 (12.7%) fulfilled the criteria for depression, 17 (7.7%) had a major depression and 11 (5.0%) had a mixed depression–anxiety condition. Conclusions: The rate of undetected depression in primary healthcare was considerable. The majority of these patients had a major depression. Psychiatric co-morbidity among depressed patients was almost universal. The two-stage procedure of opportunistic screening with the Montgomery–Åsberg Depression Rating Scale and the Primary Care Evaluation of Mental Disorders seems to be a feasible method for detecting these patients in primary healthcare.
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Openly addressing farming-specific topics and expression of appreciation in communication about mental health care might be important for actual usage.
“Openly addressing of farming-specific topics and expression of appreciation in the communication about mental health care might therefore be important for actual usage, which are highlighted by studies focusing on help-seeking behavior and intervention design in this population (Lotfi et al., 2010; Vayro et al., 2020).”
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- Authors
- Lotfi, L., Flyckt, L., Krakau, I., Mårtensson, B., & Nilsson, G. H.
- Affiliations
- Karolinska Institutet (SE)
- Corresponding author
- Flyckt, Lena
- Venue
- Nordic Journal of Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2010-04-29
- Volume
- 64
- Issue
- 6
- Pages
- 421-427
- ISSN
- 0029-1455 (ISSN-L)
- 0803-9488
- 1502-4725
- OpenAlex
- W2012011523
- Cited by
- 25
- References
- 40
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 1 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nordic Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Victoria
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- primary care, opportunistic screening, Montgomery-Asberg Depression Rating Scale, major depressive disorder, psychiatric comorbidity, depression prevalence, depression severity
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety Disorders, Major Depressive Disorder, Depressive Disorder, Major, Feasibility Studies, Female, Humans, Interview, Psychological, Male, Mass Screening, Middle Aged, Personality Inventory, Primary Health Care, Psychometrics, Sweden, Reproducibility of Results, Comorbidity, Young Adult
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