ABSTRACT
The prevalence of major depressive disorder in the primary care sector is even greater. Estimates of prevalence rates for major depression in this population have ranged from 4.8% to 8.6% (Callahan et al., 1996). When dysthymic disorder and depression not otherwise specified (NOS) are included, nearly 25% of the primary care population is thought to have a depressive disorder. Katon (1982) found that more than 33% of consecutive primary care attendees reported substantial levels of psychological distress. In addition, approximately 15% to 25% met diagnostic criteria for an affective disorder. Zung, Broadhead, and Roth (1993) found that approximately 21% of a national survey of over 75,000 patients receiving medical care by a family practice physician described significant symptoms of depression. Moreover, approximately 50% of all patients who are treated for depressive illnesses are seen exclusively in primary care clinics. It is further estimated that an additional 20% to 30% of depressed patients are treated in both specialty and primary care settings (Katon et al., 1996).
