Gaps in depression care: why primary care physicians should hone their depression screening, diagnosis, and management skills

J Occup Environ Med. 2008 Apr;50(4):451-8. doi: 10.1097/JOM.0b013e318169cce4.


Objective: To highlight the potential role that occupational and environmental physicians can play in providing high quality depression care by describing: the profound impact that depression can have on development and persistence of unexplained medical symptoms such as pain; the impact of depression on social and occupational functioning; the adverse effect of comorbid depression in patients with chronic medical illness on self-care and medical outcomes; and the significant direct and indirect costs associated with depression.

Method: Literature review.

Results: Despite evidence-based treatment guidelines, suboptimal depression care persists.

Conclusions: Building on the tenets of the chronic illness care model as well as the principles of public health, three approaches are required to address the gaps between knowledge and practice: 1) improve accuracy of diagnosis; 2) prevent chronic depression; and 3) prevent relapse and recurrence.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Clinical Competence
  • Depression / diagnosis*
  • Depression / therapy*
  • Evidence-Based Medicine
  • Humans
  • Physician's Role
  • Physicians, Family*
  • Practice Patterns, Physicians'*
  • Professional Competence*
  • Treatment Outcome