Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network

Journal Name: 
BMC.Fam Pract
Authors: 
Chin,W.Y.
Chan,K.T.
Lam,C.L.
Wong,S.Y.
Fong,D.Y.
Lo,Y.Y.
Lam,T.P.
Chiu,B.C.
Abstract: 
BACKGROUND: This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong. METHODS: A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PHQ-9 scores reported whether they thought their patients had depression and their management. RESULTS: 10,179 patients completed the survey (response rate 81%). The prevalence of PHQ-9 positive screening was 10.7% (95% CI: 9.7%-11.7%). Using multivariate analysis, risk factors for being PHQ-9 positive included: being female; aged /= two co-morbidities; having a family history of mental illness; and having a past history of depression or other mental illness. Overall, 23.1% of patients who screened PHQ-9 positive received a diagnosis of depression by the doctor. Predictors for receiving a diagnosis of depression included: having higher PHQ-9 scores; a past history of depression or other mental health problem; being female; aged >/=35 years; being retired or a homemaker; being non-Chinese; having no regular exercise; consulted a doctor within the last month; having a family history of mental health problems; and consulted a doctor in private practice.In patients diagnosed with depression, 43% were prescribed antidepressants, 11% were prescribed benzodiazepines, 42% were provided with counseling and 9% were referred, most commonly to a counselor. CONCLUSION: About one in ten primary care patients screen positive for depression, of which doctors diagnose depression in approximately one in four. At greatest risk for depression are patients with a past history of depression, who are unemployed, or who have multiple illnesses. Patients most likely to receive a diagnosis of depression by a doctor are those with a past history of depression or who have severe symptoms of depression. Chinese patients are half as likely to be diagnosed with depression as non-Chinese patients. Over half of all patients diagnosed with depression are treated with medications
2014
Volume: 
15
Pages: 
30-
Keywords: 
Adult, Aged, analysis, antidepressant, antidepressants, Comorbidity, Counseling, Depression, Diagnosis, electronic, Exercise, factors, Family, FAMILY medicine, Female, Health, history, Income, medical, Medicine, Mental Health, Methods, Multivariate Analysis, patient, Patients, practice-based research, Prevalence, primary care, Research, response, Risk, Risk Factors, survey, Universities