The Article in Brief

Major Depression Symptoms in Primary Care and Psychiatric Care Settings: A Cross-Sectional Analysis

Bradley N. Gaynes, MD, MPH, and colleagues

Background Depressed patients are more likely to see a primary care doctor than a mental health specialist for diagnosis and treatment of depression. This study compares characteristics and conditions of depressed patients in primary care and psychiatric specialty care settings.

What This Study Found Patients with major depression in primary care and specialty care settings have similar symptoms and similar levels of depression. Risk factors for suicide are commonly seen in both settings, although they are more frequent in specialty care. In each setting, more than half of depressed patients had another psychiatric illness, in addition to depression.

Implications

• These findings challenge the suggestion that depressed patients in primary care settings are less depressed than those in specialty care settings.
• Research results based on similar patient populations may be applicable to both primary care and specialty care practices.
• The care of major depression increasingly falls on primary care doctors as better treatments become available and as community mental health clinics begin restricting treatment to patients with more