December 1985

Assessing Depression in Primary Medical and Psychiatric Practices

Author Affiliations

From the Departments of Psychiatry (Drs Schulberg, Saul, Ganguli, and Frank and Ms McClelland) and Medicine (Dr Christy), (University of Pittsburgh School of Medicine. Dr Saul is now with Community Life Services, Sharon Hill, Pa.

Arch Gen Psychiatry. 1985;42(12):1164-1170. doi:10.1001/archpsyc.1985.01790350038008

• A two-stage assessment of newly admitted outpatients at community mental health centers and primary medical care centers found the Center for Epidemiological Studies Depression Scale to be highly sensitive but relatively nonspecific when compared with assessments of depression by the Diagnostic Interview Schedule. Considerably higher than usual screening scores are recommended with both patient populations to improve the efficiency of the Center for Epidemiological Studies Depression Scale. The reasons for our finding that primary care clinicians underdiagnose depressive disorder while psychiatric clinicians overdiagnose it relative to the Diagnostic Interview Schedule include varied presentations by each sector's patients, differing clinical acumen, and factors affecting third-party reimbursement.