DEPRESSIVE SYMPTOMS AMONG GENERAL MEDICAL PATIENTS - PREVALENCE AND ONE-YEAR OUTCOME

Using prospective data from the National Institute of Mental Health (N IMH) Epidemiologic Catchment Area surveys, we examined the relationshi p of depressive symptoms among patients seen by general medical practi tioners, with the subsequent development of major depressive disorder. The goals of the analysis were to determine 1) the 1-year psychiatric status of these individuals, and 2) to evaluate factors associated wi th the risk of major depressive disorder (MDD) or dysthymia. Between 1 980 and 1984, collaborators of the NIMH Epidemiologic Catchment Area p rogram recruited 18,571 adult participants after probability sampling of census tracts and households in five metropolitan areas. To assess the occurrence of psychiatric conditions over time, staff administered the Diagnostic Interview Schedule soon after sampling and again at fo llow-up 1 year later. For this analysis, the study sample was limited to respondents who reported seeing a general medical physician in the previous 6 months and who were free of current depressive disorder at the baseline interview. Overall, 41% of the general medical patients r eported experiencing at least one depressive symptom in the past 6 mon ths. Between 3 and 5% of the individuals with depressive symptoms deve loped MDD or dysthymia at the follow-up interview. Although individual s with depressed mood had a slightly higher estimated relative risk co mpared with individuals with vegetative, or nonvegetative (cognitive) depressive symptoms, no single classification of symptoms was apprecia bly more likely to signal MDD or dysthymia 1 year later. However, the risk of depression increased with the number of depressive symptoms re ported. Other characteristics which signalled an increased risk for MD D/dysthymia included gender (female sex); age (between 18 and 44 years ); and yearly household income (less than $10,000). Hispanic-Americans were more likely, and African-Americans tended to be less likely to d evelop MDD or dysthymia relative to Caucasians.