Somatic symptoms deserve our attention. Fam Syst Health ; 34 : — 3. Somatic symptoms of distress: an international primary care study. Psychosom Med ; 58 : — 8. Ethnicity and preferences for depression treatment. Gen Hosp Psychiatry ; 29 : — The P4 screener: evaluation of a brief measure for assessing potential suicidal risk in 2 randomized effectiveness trials of primary care and oncology patients.
Screening and case-finding instruments for depression: a meta-analysis. CMAJ ; : — Comprehensive vs. Contemp Clin Trials ; doi: Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med ; : — Treating anxiety in optimizing care to improve outcomes. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry ; 32 : — Increasing benzodiazepine prescriptions and overdose mortality in the United States, — Am J Public Health ; : — 8.
Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Measurement. Depression screening and management in primary care. Kurt Kroenke Kurt Kroenke. Journal List West J Med v. West J Med.
The effects of culture, gender, and somatic symptoms on the detection of depression. Author information Copyright and License information Disclaimer. Correspondence to: Dr Laura Kerr ude. See " Treating depression in patients with chronic disease " on page See " Psychological aspects of living with HIV disease " on page This article has been cited by other articles in PMC.
Open in a separate window. Cross-cultural validity of the tools One shortcoming of the Beck Depression Inventory arises with linguistic translations of its questions. In particular, the authors suggested the following: The high endorsement of question 6 could result from the central role of Catholicism in Latino culture and the belief that suffering may be the result of God punishing you for your sins Question 10 might be highly endorsed because, in Latino culture, crying has symbolic value and is appropriate and often expected in certain circumstances The high endorsement of question 14 might be due to Latinos' exclusion from stereotypic representations of beauty in Western society.
Furthermore, Latino attitudes toward beauty, argued the authors, change dramatically with age: in Latino culture, as a woman ages, beauty becomes associated with inner qualities rather than physical appearance Latinos' strong work ethic might explain why they predominantly score 0 on question Even limited absenteeism could have a profound effect on themselves and their dependents This study is particularly relevant to primary care physicians. Gender bias in screening tools It is estimated that twice as many women as men are diagnosed with depressive disorders.
Table 3 Depressive disorders that should be picked up by a screening tool for depression Major depressive disorder Chronic depressive disorder Dysthymic disorder Adjustment disorder with depressed mood Adjustment disorder with anxiety and depressed mood Atypical depressive disorder Melancholia Postpartum depressive disorder.
Table 4 Somatic symptoms that sometimes present with depression Headache, migraines Sexual dysfunction Appetite changes Menstrual-related symptoms Chronic pain Chronic medical conditions eg, diabetes, Parkinson's disease, alcoholism Digestive problems eg, diarrhea, constipation Fatigue Sleep disturbances. Figure 1. Gender bias in screening tools may lead to overdiagnosis of depression in women Israel Castro. Acknowledgments Gus M Garmel assisted with research and provided editorial suggestions.
Notes Competing interests: None declared see also p , Summary points Semantic differences between the terminology of depression screening tools and the language of some cultures may limit the diagnostic power of these tools Somatic symptoms may be more reliable indicators of depression than a patient's emotional state Scores from depression screening tools should be used to indicate the need for further evaluation—not as a basis for diagnosis Despite their limitations, self-reported depression screening tools are useful for detecting depression in the primary care setting.
References 1. World Health Organization. Accessed August 10, National DMDA anticipate health care trends. Summer, p 1. Depression in primary care: patient factors that influence recognition. Fam Med ; 29 : On the validity of the Beck Depression Inventory: a review. Psychopathology ; 31 : PubMed Abstract 4. Montorio I, Izal M. The Geriatric Depression Scale: A review of its development and utility.
Int Psychogeriatr ; PubMed Abstract 5. Psychopharmacol Bull ; PubMed Citation 6. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. PubMed Abstract 7. The PHQ Validity of a brief depression severity measure.
J Gen Intern Med ; PubMed Abstract 8. Health Psychol ; PubMed Abstract. Dr Anderson is a family physician in Sooke, British Columbia. Above is the information needed to cite this article in your paper or presentation. Solid-organ transplantation in HIV-infected patients. N Engl J Med. The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in to establish guidelines for the format of manuscripts submitted to their journals.
The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U. An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors. I am requesting permission to include a copy of your instrument in the appendix of the Methods section of my research project paper.
Depression is a common and treatable mental health condition. You do not have to cope with this alone. No one should suffer needlessly in silence. Reach out immediately. Help is always right. You will have better results if you seek depression treatment at the first signs. But, many times, people overlook it, which can lead to further harm. Skip to main content. Issue: BCMJ, vol. Michalak, PhD Raymond W. Introduction How many times have physicians wished they could measure a serum sadness level, and show the report to their skeptical patients, thus convincing them that they have a medically treatable disorder?
Have you been bothered by little interest or pleasure in doing things? Have you been feeling down, depressed, or hopeless in the last month? Measuring outcomes The Hamilton Depression Rating Scale HAM-D , the oldest, most widely used and validated instrument, has numerous versions, both clinician-rated and self-reported, as well as a computer-administered version.
Evaluation questions 1. Symptom questions 3. Loss of energy: Have you been feeling tired or having little energy? Also can be observed 9. Are you basically satisfied with your life? The World Health Organization recommends the integration of mental health into general health care in order to seal the existing gap between the number of patients who need mental health care and those who actually receive it.
Addressing the burden of mental health problems in primary care settings has its limitations, particularly because of the time constraints in busy primary care clinics as well as the inadequate training of staff and physicians in mental health disorders.
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