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. 2002 Apr 15;29(6):329-36; discussion 336-7.
doi: 10.1016/s0212-6567(02)70578-7.

[Prevalence and detection of depressive disorders in primary care]

[Article in Spanish]
E Gabarrón Hortal  1 , J M Vidal Royo, J M Haro Abad, I Boix Soriano, A Jover Blanca, M Arenas Prat
Affiliations

[Prevalence and detection of depressive disorders in primary care]

[Article in Spanish]
E Gabarrón Hortal et al. Aten Primaria. .

Abstract
in English, Spanish

Aim: To study the prevalence of depression in primary care, the detection of depressive disorders by primary care physicians, and the factors that influence detection.

Design: Cross-sectional, descriptive study.

Setting: Gavà II Primary Care Center, in Barcelona, Spain.

Participants: A total of 400 people between the ages of 18 and 65 years were chosen randomly from among those who attended appointments with their primary care physician.

Main measures: A sociodemographic questionnaire and the Beck Depression Inventory (BDI) screening test were administered, and the participant s medical record was reviewed. In a subsample of 40 participants, the Mini-International Neuropsychiatric Interview (MINI) was also administered. The optimum cutoff score for the BDI was estimated with reference to the MINI results.

Results: A cutoff score of 20/21 for the BDI had a sensitivity of 86.7% and a specificity of 92%, when the MINI score was used as a reference. The adjusted prevalence of depressive disorder in our primary care setting was 20.2% overall, 8.1% in men, and 26.8% in women (odds ratio 4.15, p < 0.01). The physician detected depressive symptoms in 55.7% of all likely cases of depression. Persons who scored >= 21 on the BDI made more visits to their primary care physician, and had more stressful life events, than those who scored 20.

Conclusions: The prevalence of depression in our primary care setting is high. The disorder was underdiagnosed in as many as 44.3% of the persons likely to have depressive disorder (especially women, widows and widowers, retired persons, persons who had experienced stressful life events, and frequent users of primary care services).

Objetivo: Estudiar la prevalencia de depresión en atención primaria (AP) y la detección de los trastornos depresivos por el médico de AP, así como los factores que influyen en ella.

Diseño: Estudio transversal, descriptivo.

Emplazamiento: Centro de Asistencia Primaria Gavà II (Barcelona).

Participantes: Se seleccionaron de manera aleatoria 400 personas de 18–65 años que acudieron según cita previa a consulta con su médico de AP.

Mediciones principales: Se administró un cuestionario sociodemográfico, el test de cribado de depresión de Beck (BDI) y se revisaron los datos clínicos de su historia. Además a una submuestra de 40 personas se les pasó la entrevista diagnóstica MINI. Se estimó el punto de corte óptimo para el BDI respecto la MINI.

Resultados: Se seleccionó el punto de corte 20/21 de depresión del BDI, con sensibilidad del 86,7% y especificidad del 92%, utilizando como referencia el resultado de la entrevista MINI. La prevalencia corregida del trastorno depresivo en AP es de un 20,2%; un 8,1% en varones y el 26,8% en mujeres (odds ratio [OR] = 4,15; p < 0,01). El médico detecta sintomatología depresiva en un 55,7% de los probables casos de depresión. Las personas con BDI 3 21 visitan más a su médico de AP y han presentado más acontecimientos vitales estresantes que las que puntúan BDI £ 20.

Conclusiones: Existe una elevada prevalencia de depresión en AP. Permanece infradiagnosticado un 44,3% de las personas con probable trastorno depresivo (sobre todo mujeres, viudos, jubilados, los que han presentado acontecimientos vitales estresantes y los individuos más frecuentadores).

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