Depression in primary care. A nationwide epidemiological survey

Background. Most epidemiological studies on depression in primary care are conducted at single sites, and variations in reported prevalence may depend on characteristics of health care services and other local factors. Objectives. Our aim was to investigate the prevalence of depression in primary care in Italy and its association with physical illness, disability and health care utilization. Methods. This nationwide epidemiological study involved 191 primary care physicians (PCPs) who assessed during one index week 1896 patients aged 14 and over attending their clinics. Screening was conducted by using the General Health Questionnaire-12. Probable cases were assessed by PCPs with the WHO ICD-10 Checklist for Depression and rated for severity of physical illness. Results. The prevalence of current depression ranged between 7.8 and 9.0% in the three main Italian areas, with no significant variations. A linear increase from North to South was observed for psychological distress, disability and frequency of medical consultation. Depression was associated with severe, but not with mild or moderate physical illness. Depression was also associated with disability and accounted for an increased rate of consultation. Conclusion. Because of the disability associated with depression and of its impact on health care utilization, guidelines and intervention strategies are needed.