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Depressive Disorder in Primary Care

Published online by Cambridge University Press:  02 January 2018

C. V. R. Blacker  and
A. W. Clare
C. V. R. Blacker
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital, London EC1A 7BE
A. W. Clare*
Affiliation:
Department of Psychological Medicine, St Bartholomew's Hospital, London EC1A 7BE
*
∗Correspondence
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Abstract

Since the pioneering study of psychiatric morbidity in primary care by Shepherd et al in 1966, it has become increasingly apparent that a substantial proportion (between 20% and 25%) of patients consulting their GP are suffering from some form of psychiatric disturbance (Goldberg & Blackwell, 1970; Hoeper et al, 1979). The composition of this psychiatric morbidity has been shown to be almost wholly affective in nature and largely mild in degree. In their important review Jenkins & Shepherd (1983) recently summarised the now extensive findings relating to overall minor psychiatric morbidity in primary care. However, recent collaborative studies between psychiatrists and GPs have identified that within this dilute pool of minor disorders, lurks a significant but poorly served population of patients suffering from depressive disorders which are by no means minor in degree. A number of crucial issues regarding this depression in primary care emerge which the present paper aims to review. In particular, how common is it, and how severe? How does it present and what, if any, are its special characteristics? What is the precise relationship between depressive symptoms and depressive illness presenting to the GP and what is the relationship between physical illness and depression? And finally, what is the course and outcome of depression in this setting and what are the indications for and effect of treatment?

Type
Review Article
Information
The British Journal of Psychiatry , Volume 150 , Issue 6 , June 1987 , pp. 737 - 751
Copyright
Copyright © 1987 The Royal College of Psychiatrists 

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