Nonpsychiatric physicians' identification and treatment of depression in patients with diabetes

Patrick J. Lustman, Gary W. Harper

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Abstract

The recognition of depression by nonpsychiatric physicians was studied in a group of patients with diabetes mellitus. One hundred fourteen patients participating in a longitudinal study of diabetes control and complications also agreed to undergo psychiatric evaluation. Twenty-eight (24.6%) of these patients satisfied the Diagnostic and Statistical Manual of Mental Disorders (ed 3) (DSM-III) criteria for major depressive episode. Outpatient and inpatient medical records of these patients were examined and compared to those from a control group of 28 patients without psychiatric diagnosis (psychiatrically well). Physicians recorded the presence of abnormal psychological features (e.g., anxious or depressed mood) in 19 (68%) of the depressed patients and in 1 (3.4%) of the controls (χ2 = 22.5, P < .001). A clinical diagnosis of depression, however, was assigned to only 10 (35.7%) of the depressives and to none (0.0%) of the controls (χ2 = 14.4, P < .001). Fourteen (50%) of the patients with depression were prescribed one or more psychotropic medications (10 were given antidepressants); 3 (10.7%) of the controls were prescribed these drugs (χ2 = 8.4, P < .01). We conclude that diabetologists do correctly identify features of depression in patients with diabetes. However, in only approximately one third of cases is the diagnosis recorded and treatment initiated.

Original languageEnglish
Pages (from-to)22-27
Number of pages6
JournalComprehensive Psychiatry
Volume28
Issue number1
DOIs
StatePublished - 1987

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