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首页> 外文期刊>BMC Family Practice >Screening and diagnosing depression in women visiting GPs' drop in clinic in Primary Health Care
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Screening and diagnosing depression in women visiting GPs' drop in clinic in Primary Health Care

机译：初级卫生保健中前往GP诊所就诊的妇女的抑郁症筛查和诊断

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Background Only half of all depressions are diagnosed in Primary Health Care (PHC). Depression can remain undetected for a long time and entail high costs for care and low quality of life for the individuals. Drop in clinic is a common form of organizing health care; however the visits are short and focus on solving the most urgent problems. The aim of this study was to investigate the prevalence and severity of depression among women visiting the GPs' drop in clinic and to identify possible clues for depression among women. Methods The two-stage screening method with "high risk feedback" was used. Beck's Depression Inventory (BDI) was used to screen 155 women visiting two GPs' drop in clinic. Women who screened positive (BDI score ≥10) were invited by the GP to a repeat visit. Major depression (MDD) was diagnosed according to DSM-IV criteria and the severity was assessed with Montgomery-Asberg Depression Rating Scale (MADRS). Women with BDI score Results The two-stage method worked well with a low rate of withdrawals in the second step, when the GP invited the women to a repeat visit. The prevalence of depression was 22.4% (95% CI 15.6–29.2). The severity was mild in 43%, moderate in 53% and severe in 3%. The depressed women mentioned mental symptoms significantly more often (69%) than the controls (15%) and were to a higher extent sick-listed for a longer period than 14 days. Nearly one third of the depressed women did not mention mental symptoms. The majority of the women who screened as false positive for depression had crisis reactions and needed further care from health professionals in PHC. Referrals to a psychiatrist were few and revealed often psychiatric co-morbidity. Conclusion The prevalence of previously undiagnosed depression among women visiting GPs' drop in clinic was high. Clues for depression were identified in the depressed women's symptom presentation; they often mention mental symptoms when they visit the GP for somatic reasons e.g. respiratory infections. We suggest that GPs do selective screening for depression when women mention mental symptoms and offer to schedule a repeat visit for follow-up rather than just recommending that the patient return if the mental symptoms do not disappear.
机译：背景信息所有抑郁症中只有一半是在初级卫生保健（PHC）中诊断出来的。抑郁症很长一段时间都不会被发现，并且会给患者带来高昂的护理费用和较低的生活质量。到诊所就诊是组织医疗保健的一种常见形式。然而，这次访问是短暂的，着重于解决最紧迫的问题。这项研究的目的是调查前往GP诊所就诊的女性中抑郁症的患病率和严重程度，并确定女性抑郁症的可能线索。方法采用“高风险反馈”的两阶段筛选方法。贝克的抑郁量表（BDI）用于筛查155名前往两名全科医生就诊的妇女。 GP邀请筛查阳性（BDI评分≥10）的妇女再次访视。根据DSM-IV标准诊断为严重抑郁症（MDD），并使用蒙哥马利-阿斯伯格抑郁量表（MADRS）评估严重程度。具有BDI评分的女性结果当GP邀请女性再次访问时，两阶段方法效果很好，第二步的退出率很低。抑郁症的患病率为22.4％（95％CI 15.6-29.2）。轻度为43％，中度为53％，重度为3％。抑郁的妇女提及精神症状的频率明显高于对照组（占15％）（69％），而且在病态上的病程长于14天。近三分之一的抑郁症妇女没有提及精神症状。筛查为抑郁症假阳性的大多数妇女有危机反应，需要初级卫生保健人员的进一步护理。转诊给精神科医生的人数很少，而且经常显示出精神病合并症。结论前往GP诊所就诊的女性中先前未被诊断出的抑郁症患病率很高。在抑郁症妇女的症状表现中发现了抑郁症的线索。当他们出于身体原因访问GP时，他们经常提到精神症状，例如呼吸道感染。我们建议，当女性提及精神症状时，家庭医生会进行抑郁症的选择性筛查，并建议安排重复随访以进行随访，而不是建议如果精神症状没有消失则建议患者返回。

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