729 Validity Of The Diagnosis Of Depression In The Catalan Primary Care. Results From De Dasmap Study.

Conference: 
Author(s): 
Anna Fernandez Sanchez - Sant Joan de Déu-SSM
Alejandra Pinto-Meza - Sant Joan de Déu-SSM
Pere Roura - Clinical Epidemiology Unit. Vic General Hospital
Diego Palao - Psychiatry Service. Parc Tauli Hospital.
Josep Maria - Sant Joan de Déu-SSM
Antoni Serrano-Blanco - Sant Joan de Déu-SSM
Text: 
Oral Communication
Aims: To explore the validity of the diagnosis of depression made by primary care physicians (PCP) using the ICD-9 or ICD-10 and the cases of depression identified by trained clinical interviewers using the SCID-I (as gold standard).
Design: The DASMAP study was an epidemiological survey carried out in 80 Catalan Primary Care Centres randomly selected among those with a coverage area higher than 10,000 inhabitants. The sample was composed by 3,815 patients (response rate was nearly 70%). The survey was conducted between December 2005 and February 2006.
Results: The 12-month prevalence of Major Depression according to the SCID-I was 9.60% (95%CI:8.00%-11.19%; N=339). PCP only identified 51 out of the 339 individuals identified with the SCID-I (sensitivity 0.15). Although specificity was high (0.96), only a quarter of the patients identified by the PCP met criteria for depression (positive predictive value of PCP diagnosis=0.25). Kappa value was 0.13. After adjusting by socio-demographic (gender, age, marital status, educational level, and working status) and clinical characteristics (past presence of depression, family psychiatric history, and mental health quality of life), only the presence of mental or emotional problems as the primary patients'; complaint was associated to an increased probability of recognition (OR=2.24;95% CI:1.05-4.75).
Conclusions: It has been suggested that PCP rarely use psychiatric diagnostic categories, basing their decisions in a dimensional standpoint (severity). Therefore, low rates of PCP recognition of depression could rely on the “gold standard” used in our study.
Literature: 
729
VALIDITY OF THE DIAGNOSIS OF DEPRESSION IN THE CATALAN PRIMARY CARE. RESULTS FROM DE DASMAP STUDY.