ABSTRACT
This chapter reviews three measures that have historically been used to assess depressive disorders in primary care populations: the Beck Depression Inventories, the Center for Epidemiological Studies Depression Scales, and the Patient Health Questionnaires. Available primary care screening instruments at the time tended to have lower diagnostic specificity, thus overestimating rates of depression due to overlap between the performance and somatic symptoms of depression and various aspects of medical illness, such as poor appetite or fatigue. The high prevalence of depressive symptoms in primary care coupled with the poorer health outcomes and higher healthcare utilization in patients whose depression goes unrecognized have fueled a demand for instruments that can be administered easily in clinical settings to a wide variety of populations. Higher cut scores may be employed if the patient population being assessed has a higher baseline rate of depression, or the clinician is interested in identifying individuals more likely to meet full diagnostic criteria for a depressive disorder.
