Prevalence, nature, and comorbidity of depressive disorders in primary care

Gen Hosp Psychiatry. 1994 Jul;16(4):267-76. doi: 10.1016/0163-8343(94)90006-x.


This article examines the prevalence, nature, and comorbidity of depressive disorders using DSM-III-R criteria among patients recruited from the waiting rooms of family physicians. A total of 1928 family practice patients completed a screening form including the Center for Epidemiologic Studies-Depression Scale (CES-D), and patients with elevated CES-D scores were oversampled for possible interviews using the Structured Clinical Interview for the DSM-III-R (SCID). In the resulting weighted sample of 425, a prevalence of 13.5% was obtained for major depression and 22.6% for all depressive disorders. Over 40% of the patients with major depressive disorder (MDD) were only mildly depressed. Gender and other demographic variables failed to distinguish depressed patients, but a variety of self-ratings did. Depression was associated with comorbid anxiety disorders and substance abuse. Results are discussed in terms of the implications of depression in primary care as a public health problem, but also in terms of some diagnostic issues, particularly the use of an impairment criterion for major depression.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / psychology
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Incidence
  • Male
  • Mental Disorders / epidemiology
  • Mental Disorders / psychology
  • Michigan / epidemiology
  • Middle Aged
  • Personality Assessment / statistics & numerical data
  • Personality Inventory / statistics & numerical data
  • Primary Health Care
  • Psychometrics
  • Psychophysiologic Disorders / epidemiology*
  • Psychophysiologic Disorders / psychology
  • Somatoform Disorders / epidemiology*
  • Somatoform Disorders / psychology