Identifying depression in primary care:: a comparison of different methods in a prospective cohort study

Depressive disorders are a major health problem in primary care, and at least half of these disorders remain undetected.(1) There are two recommended approaches to diagnosing depression in primary care: one is to perform routine screening, and the other is to evaluate patients only when the clinical presentation triggers the suspicion of depression. Our aim was to compare these two approaches, and to compare three different screening tools in order to evaluate which would be most appropriate for use in primary care. Front among the many available screening tools, we selected three brief, self rating instruments: one disorder-specific (the depression module of the brief patient health questionnaire (B-PHQ, 9 items)),(2) one broad based (the general health questionnaire (GHQ-12, 12 items)),(3) and one that is less restricted to both issues (WHO-5 wellbeing index (WHO-5, 5 items))(4).