SHOULD GENERAL-PRACTITIONERS BE TESTING FOR DEPRESSION

While most patients with recognized depressive illness are treated by general practitioners without referral, there is evidence that many pa tients classifiable as depressed after psychiatric interview are not d iagnosed as such. Missing depression is of great importance since it i s now eminently treatable. This paper explores the use in primary care of questionnaire tests for depression and also their role in case fin ding in vulnerable groups of patients. The potential of existing valid ated questionnaires in clinical work and audit is largely unexploited. As yet, however, there is no gold standard for the diagnosis of depre ssion seen in primary care. Clusters of symptoms do not yet accurately predict the course of the illness or response to treatment. More rese arch is needed on the natural history of depression seen in the commun ity, as well as on treatment and outcome.