Major depression in primary care: making the diagnosis

Singapore Med J. 2016 Nov;57(11):591-597. doi: 10.11622/smedj.2016174.

Abstract

Major depression is a common condition seen in the primary care setting, often presenting with somatic symptoms. It is potentially a chronic illness with considerable morbidity, and a high rate of relapse and recurrence. Major depression has a bidirectional relationship with chronic diseases, and a strong association with increased age and coexisting mental illnesses (e.g. anxiety disorders). Screening can be performed using clinical tools for major depression, such as the Patient Health Questionaire-2, Patient Health Questionaire-9 and Beck Depression Inventory, so that timely treatment can be initiated. An accurate diagnosis of major depression and its severity is essential for prompt treatment to reduce morbidity and mortality. This is the first of a series of articles that illustrates the approach to the management of major depression in primary care. Our next articles will cover suicide risk assessment in a depressed patient and outline the basic principles of management and treatment modalities.

Keywords: major depression; primary care.

MeSH terms

  • Chronic Disease
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / diagnosis*
  • Disabled Persons
  • Humans
  • Mass Screening
  • Primary Health Care / methods*
  • Psychometrics
  • Recurrence
  • Risk Assessment
  • Suicide Prevention
  • Surveys and Questionnaires