How disabling is depression? Evidence from a primary care sample

Background. Major depression is an illness with a high prevalence and is mo st commonly seen and treated by general practitioners (GPs). Aim. To determine the level of disability in depressed patients seen in a p rimary care setting, and to investigate whether the level of disability was associated with the severity of the depression. Method. Prospective data collection, using the 36-item Shortened Form (SF-3 6), from the Medical Outcomes Study, as a measure of disability, and from t he Beck Depression Inventory (BDI) in a sample of depressed patients recrui ted from a Counselling versus Antidepressant in Primary Care (CAPC) study i n the Trent Region. All patients met the research diagnostic criteria for m ajor depression. Results. Two hundred and fifty patients were assessed. These patients repor ted high levels of disability compared both with published norms and with o ther chronic physical illnesses. Increases in disability were especially no ticeable in the domains of the SF-36 that were specific to mental illness. There was a significant correlation between scores on the SF-36 and the BDI . Conclusion. This study confirms that depressed patients in primary care rep ort high levels of disability on the SF-36, and that the instrument is both specific to the domains expected to be affected by mental disorder and is sensitive to the severity of mood disturbance.