Minor depression in family practice: functional morbidity, co-morbidity, service utilization and outcomes

Background. Minor depression is a disabling condition commonly seen in prim ary care settings. Although considerable impairment is associated with mino r depression, little is known about the course of the illness. Using a vari ety of clinical and functional measurements, this paper profiles the course of minor depression over a 1 year interval among a cohort of primary care patients. Method. Patients at a university-based primary care facility were screened for potential cases of depression and selected into three diagnostic catego ries: an asymptomatic control group; patients with a diagnosis of major dep ression; and, a third category, defined as minor depression, consisting of patients who reported between two and four symptoms of depression, but who failed to qualify for a diagnosis of major depression. Functional status, s ervice use, and physical, social and mental health were assessed at baselin e and at 3-month intervals for the ensuing year. Results. Respondents with a baseline diagnosis of minor depression exhibite d marked impairment on most measures both at baseline and over the followin g four waves. Their responses in most respects were similar to, although no t as severe as, those of respondents with a baseline diagnosis of major dep ression. Both groups were considerably more impaired than asymptomatic cont rols. Conclusions. Minor depression is a persistently disabling condition often s een in primary care settings. Although quantitatively less severe than majo r depression, it is qualitatively similar and requires careful assessment a nd close monitoring over the course of the illness.