WHY DO GENERAL-PRACTITIONERS RECOGNIZE MAJOR DEPRESSION IN ONE WOMAN PATIENT YET MISS IT IN ANOTHER

The aim of this study was to establish whether psychiatric patient cha racteristics and the presence of physical illness affected general pra ctitioners' recognition of major depressive illness in women patients. The 30-item general health questionnaire was used as a first stage sc reening instrument for psychiatric morbidity and each patient selected was interviewed, usually within three days of consulting their genera l practitioner, using the combined clinical interview. A sample of 72 women with major depressive disorder was obtained from patients consul ting 36 general practitioners mainly from the south west Thames region of England, each general practitioner providing one patient he or she had correctly recognized as being depressed and one patient whose dep ression had not been recognized. Few differences were found between th e groups with recognized and unrecognized depression in their psychiat ric or physical features. More patients with unrecognized depression e xperienced physical illness and were tired Patients with serious physi cal disease were five times more likely not to be recognized as depres sed than those without physical disease. Patients with recognized depr ession described a more distinct quality to their depressed mood Women with unrecognized major depression are similar to those women whose m ajor depression is recognized by their general practitioner. These fin dings require further elaboration by process and content analysis of t he women's consultations.