Deprese v primární péči

Depressions in Primary Care

The authors investigated in a grant project the incidence of depressive disor-ders in subjects who visit surgeries of general practitioners. The investigati-on was made in three surgeries in a large city, a small city and in a ruralarea.In the documentation of the general practitioner in a sample of 200 patientssymptoms of depressions were recorded in 12.5% of those attending the sur-gery and on average six of the classical symptoms per person were recordedin writing. Psychopharmaceutical drugs (incl. hypnotics) were prescribed to22.5% patients, most frequently (65%) anxiolytics. Only one patient was refer-red to a psychiatrist for examination.The score of subjective symptoms according to the General Health Question-naire (GHQ-30) revealed in a sample of 558 patients of general practitionersthe highest frequency of 20-30 points (38.5% of the subjects) and 30-40 points(25% of the subjects). Highly probable patients with all psychic disordersnumbered 18% and probable ones 36%.General practitioners diagnosed mental disorders as the main diagnosis in0.6% of patients’ visits, they assessed an influence of psychic factors on thepatient’s health status in 3.9% and depressive symptoms only in 0.4% of theirpatients.During a 6-month follow-up the mean number of visits to the general practiti-oner in the group of depressive patients (29 subjects), as assessed by GHQ-30,was higher (11.1%) than in the whole group of all patients. Also the number ofrecorded medical operations and number of prescribed medicaments washigher in the group of depressed patients. Psychopharmaceutical preparati-ons were prescribed to 41.4% depressive patients while only to 15.7% in thegroup as a whole. Mainly anxiolytics were prescribed and only quite excepti-onally antidepressants.When the general practitioner drew attention to the fact that the patient hadsymptoms of depression, this probably led to changes in the therapeuticprocedure.

Key words:
depression, screening, questionnaires, general practitioner.