DEPRESSIVE-DISORDERS IN JAPANESE PRIMARY-CARE PATIENTS

In a sample of 276 Japanese adult patient attenders at two primary car e clinics affiliated with the Department of Hygiene and Preventive Med icine at the Okayama University Medical School major depression was di agnosed in 5.8% and minor depression in 7.2% of patients studied. Func tional impairment was significantly more severe in patients with eithe r major or minor depression than in those not affected. None of the 36 patients with major or minor depression had received a diagnosis of d epression or had been given antidepressant therapy. Possible explanati ons for the marked underdiagnosis of depression and lack of specific a ntidepressant therapy in these patients include severe stigma associat ed with a diagnosis of mental disorders, focus of the mental health sy stem on hospitalization with consequent trivialization of mental probl ems in ambulatory patients, and the extraordinarily high work load of primary care doctors.