Identifying patients with depression in primary healthcare

Paula Jankowska, Krzysztof Jankowski, Ewa Rudnicka-Drożak


It is estimated that in 2015 in Poland 1 878 988 patients suffered from depression. Depressive disorder is associated with significant decrease of life quality. Untreated depression can be fatal, as it is a recognized risk factor for a suicide attempt. Thus, identification of patients with symptoms of depressive disorder in primary healthcare is very important, as rapid implementation of treatment can prevent unfavorable depression effects.
The aim of this study is to present ways of identification patients with depressive disorder and screening tools suitable for primary healthcare setting.
Careful physical examination and history taking are highly important in depresion case finding. Patients may present with many uncharacteristic somatic complaints. Moreover, there are some group of patients that are at higher risk of depressive disorder. The most important one includes patients with other mental disorders; previous history of depression and familial predisposition to depression. There are many depression screening tools. The most popular are Patient Health Questionnaire, Beck Depression Inventory and Geriatric Depression Scale.
Many individuals, finally diagnosed with depressive disorder, meet their family doctor for uncharacteristic complaints. This is highly important for primary care physicians to be acquainted with most common somatic manifestations of depression. In primary care setting PHQ-2, PHQ-9 can be successfully used. BDI-PC also appears as measure suitable for family physicians. Geriatric population should be assessed with use of shorter version of GDS, but PHQ-2, and PHQ-9 are also recommended for this age group.


Depressive Disorder, Screening, Primary Health Care

Full Text:



Depression and Other Common Mental Disorders Global Health Estimates, World Health Organization,;jsessionid=CD84DD410E0C759ECD8E1269B57BCCC9?sequence=1 /accessed 07.07.2018/

Lovejoy MC, Graczyk PA, O'Hare E, Neuman G. Maternal depression and parenting behavior: a meta-analytic review. Clin. Psychol. Rev. 2000; 20:561–592.

Wilson S, Durbin CE. Effects of paternal depression on fathers' parenting behaviors: a metaanalytic review. Clin. Psychol. Rev. 2010; 30:167–180.

Kronmuller KT, Backenstrass M, Victor D, Postelnicu I, Schenkenbach C, et al. Quality of marital relationship and depression: results of a 10-year prospective follow-up study. J. Affect. Disord. 2011; 128:64–71.

Kessler RC, Heeringa S, Lakoma MD, Petukhova M, Rupp AE, et al. Individual and societal effects of mental disorders on earnings in the United States: results from the national comorbidity survey replication. Am. J. Psychiatry. 2008; 165:703–711.

Van der Kooy K, van Hout H, Marwijk H, Marten H, Stehouwer C, Beekman A. Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry. 2007;22:613-26.

Knol MJ, Twisk JW, Beekman AT, Heine RJ, Snoek FJ, Pouwer F. Depression as a risk factor for the onset of type 2 diabetes mellitus. A meta-analysis. Diabetologia. 2006;49:837-45.

Conwell Y, Duberstein PR, Cox C, et al. Relationships of age and axis I diagnoses in victims of completed suicide: a psychological autopsy study. Am J sychiatry. 1996;153:1001–1008.

Reid MC, Williams CS, Concato J, Tinetti ME, Gill TM. Depressive symptoms as a risk factor for disabling back pain in community-dwelling older persons. J Am Geriatr Soc. 2003;51: 1710-7.

Patel V. (2001) Cultural factors and international epidemiology. Br Med Bull 57: 33–45

The effectiveness of case-finding for mental health problems in primary care. Br J Gen Pract 2005;55:665 – 9. /accessed 07.07.2018/

Simon GE, Von Korff M, and Piccinelli M. et al. An international study of the relation between somatic symptoms and depression. N Engl J Med. 1999 341:658–659.

Ohayon MM, Schatzberg AF. Using chronic pain to predict depressive morbidity in the general population. Arch Gen Psychiatry 2003; 60:39-47.

Yamamoto K, Shiota S, Ohno S et al.: A diagnosis of depression should be considered in patients with multiple physical symptoms in primary care clinics. Tohoku J Exp Med 2013; 229: 279-85.

Beltrus PA, Elmore SK, Hamilton PA: Women and somatization: unrecognized depression. Health Care Women Int, 1995; 16(14)-.287-297.

Kelly, R.H., Russo, J., & Katon, W. Somatic complaints among pregnant women cared for in obstetrics: normal pregnancy or depressive and anxiety symptom amplification revisited?. General Hospital Psychiatry, 2001, 23, 107-113

Drayer RA, Mulsant BH, Lenze EJ, Rollman BL, Dew MA, Kelleher K et al. Somatic symptoms of depression in elderly patients with medical comorbidities. Int J Geriatr Psychiatry 2005;20:973-982.

Shulman RW. The serotonin syndrome: a tabular guide. Can J Clin Phanuaco. 1995; 2: 139-44.

Zisook S. Depresja w późnym wieku. Medycyna po Dyplomie. 1997; 6: 175-82

Brown R.P., Sweeney J., Loutsch E., Kocsis J., Frances A. Involutional melancholia revisited. A. J. Psychiatry. 1984; 141: 24-8.

Coventry PA, Bower P, Keyworth C, et al. The effect of complex interventions on depression and anxiety in chronic obstructive pulmonary disease: systematic review and meta-analysis. PLoS One 2013; 8: e60532.

Mezuk B, Eaton WW, Albrecht S, Hill-Golden S. Depression and type 2 diabetes over the lifespan: A meta-analysis. Diabetes Care 2008; 31:2383-2390

Tennant C. Life events, stress and depression: a review of recent findings. Aust N Z J Psychiatry 2002; 36:173-82.

Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003; 41(11):1284–1292.

Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of the prime-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282(18):1737–1744.

Mitchell AJ, Coyne JC. Do ultra-short screening instru¬ments accurately detect depression in primary care? Br J Gen Pract. 2007;57(535):144-151.

Whooley MA, Avins AL, Miranda J, et al. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12(7):439-445.

Arroll B, Goodyear-Smith F, Crengle S, et al. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med 2010;8:348–53.

Nease DE Jr, Maloin JM. Depression screening: a practi¬cal strategy. J Fam Pract. 2003;52(2):118-124.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4:561-71.

Arnau RC, Meagher MW, Norris MP, Bramson R. Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients. Health Psychol. 2001;20(2):112–9.

Beck AT, Guth D, Steer RA, Ball R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Thera. 1997;35:785-91.

Steer RA, Cavalieri TA, Leonard DM, Beck AT: Use of the Beck Depression Inventory for Primary Care to screen for major depression disorders. Gen Hosp Psychiatry 1999; 21: 106 –11.

Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983;17:37-49.

Lyness JM, Noel TK, Cox C, et al. Screening for depression in elderly primary care patients. A comparison of the Center for Epidemiologic Studies-Depression Scale and the Geriatric Depression Scale. Arch Intern Med 1997; 157:449–454.

Hoyl MT, Alessi CA, Harker JO, et al. Development and testing of a five‐item version of the Geriatric Depression Scale. J Am Geriatr Soc. 1999;47: 873–8.

Watson LC, Pignone MP. Screening accuracy for late-life depression in primary care: a systematic review. J Fam Pract. 2003;52(12):956-964.



  • There are currently no refbacks.

Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

POL-index 2011 - 2014

BASE 2011 - 2014

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

Find a library that holds this journal:

Journal Language(s): English 

PBN Poland



Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2 Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase


Universal Impact Factor 1.78 for year 2012. (

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ)

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski