How does depression present in general practice?

Abstract

This was a retrospective study of the records of Chinese patients diagnosed as having depression in a general practice clinic in Hong Kong. The records of 66 newly diagnosed patients during the period September 1, 1992 to April 30, 1994 were reviewed for their initial presenting symptoms and depressive symptoms. Ninety-four per cent of the patients with depression initially presented with somatic symptoms. The spectrum of complaints was broad with symptoms referred to various organ systems. The most common presenting complaint was sleep disturbance. Ninety per cent of the patients had three or more DSM-III-R depressive symptoms. One third satisfied the DSM-III-R criteria for depression by having five or more symptoms. The study showed that general practice patients with depression have a broad spectrum of illnesses with a wide variety of presentations, symptomatology, and severity. Chinese patients with depression tend to present initially with somatic symptoms but admit to having psychological symptoms on further exploration. General practitioners need to ask specifically for psychological symptoms in order to detect the hidden depression of many Chinese patients.