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Primary Care Identification of Depression Examined

Meta-analysis faults accuracy of brief assessments; suggests follow-up visits

TUESDAY, July 28 (HealthDay News) -- General practitioners correctly identify only about half of patients with depression, and misidentifications outnumber missed cases, according to a study published online July 28 in The Lancet.

Alex J. Mitchell, of Leicester General Hospital in the United Kingdom, and colleagues conducted a meta-analysis of 41 studies that included 50,371 patients.

The researchers found that general practitioners correctly diagnosed only about 50 percent of true cases of depression and treated only 15 percent of them. They also found that general practitioners correctly ruled out depression about 80 percent of the time. In every 100 unselected cases seen in primary care, they estimated that the number of false positives (15) is higher than that for either missed cases (10) or identified cases (10).

"Because one-off brief assessments only facilitate identification of about half of those with depression, we suggest that additional consultation time should be available for those likely to have depression. Repeated assessments by the general practitioner or other professional in a collaborative model with a case manager might help to reduce diagnostic errors and improve overall quality of care," the authors conclude.

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