A qualitative study of depression in primary care: missed opportunities for diagnosis and education

UMMS Affiliation

Meyers Primary Care Institute; Department of Family Medicine and Community Health

Publication Date


Document Type



Academic Medical Centers; Adult; Depression; Female; Humans; Interviews as Topic; Male; Middle Aged; *Patient Education as Topic; *Primary Health Care; Washington


Health Services Research | Mental and Social Health | Mental Disorders | Primary Care


PURPOSE: Depression is one of the most commonly encountered chronic conditions in primary care, yet it remains substantially underdiagnosed and undertreated. We sought to gain a better understanding of barriers to diagnosis of and entering treatment for depression in primary care.

METHODS: We conducted and analyzed interviews with 15 subjects currently being treated for depression recruited from primary care clinics in an academic medical center and an academic public hospital. We asked about experiences with being diagnosed with depression and starting treatment, focusing on barriers to diagnosis, subject understanding of depression, and information issues related to treatment decisions.

RESULTS: Subjects reported many visits to primary care practitioners without the question of depression being raised. The majority had recurrent depression. Many reported that they did not receive enough information about depression and its treatment options. In the majority of cases, practitioners decided the course of treatment with little input from the patients.

CONCLUSIONS: In this sample of depressed patients, we found evidence of frequent missed diagnoses, substantial information gaps, and limited patient understanding and choice of treatment options. Quality improvement efforts should address not only screening and follow-up but patient education about depression and treatment options along with elicitation of treatment preferences.

DOI of Published Version



J Am Board Fam Med. 2007 Jan-Feb;20(1):28-35. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American Board of Family Medicine : JABFM

Related Resources

Link to Article in PubMed

PubMed ID