Primary care physicians should be asking their patients questions about five 'warning flag' symptoms to determine whether they should be screened for depression or other mood disorders, researchers say.
"In a health care system in which primary care physicians increasingly act as gatekeepers to other services, recognition of depressive symptoms may be critical in order for a patient to gain access to professional mental health care," write Cheryl N. Carmin, Ph.D., of the University of Illinois at Chicago, and John W. Klocek, Ph.D., of the University of Montana in the Fall issue of the International Journal of Psychiatry in Medicine (Vol. 28, No. 3).
Carmin and Klocek had 357 consecutive patients at a university-based family practice clinic complete the Beck Depression Inventory, a 21-item questionnaire that has been validated extensively. Overall, 15.7 percent of the sample reported significant symptoms of depression. Among these, five symptoms were reported by at least 90 percent:
* Less enjoyment from usual activities
* Disappointment with self
* Hopelessness
* Irritability
* Difficulty sleeping
The researchers also found distinct gender differences. Women reported self-disappointment with the greatest frequency, while men most often reported dissatisfaction and difficulty sleeping.
Other symptoms on the women's top five list, in descending order, were irritability, hopelessness, dissatisfaction, and sleep difficulties. Among men, the next most frequently reported symptoms were self-criticism, difficulties completing work, fatigue, irritability, hopelessness, and disappointment with self.
"These findings suggest that a means for efficiently identifying individuals who warrant screening for depression may be readily available to primary care physicians," Carmin and Klocek write. "Attending to these symptoms or complaints during the course of an office visit may serve as an indicator that a thorough screening for depression, or possibly referral, is warranted."
The International Journal of Psychiatry in Medicine is published quarterly by Baywood Publishing Company and covers biopsychosocial aspects of primary care. For information about the Journal, contact the editor, Thomas E. Oxman, M.D., at 603-650-6147.
Posted by the Center for the Advancement of Health . For information about the Center contact Richard Hebert, rhebert@cfah.org 202-387-2829.
Journal
The International Journal of Psychiatry in Medicine