• Weng Yee Chin, Kit T Y Chan, Cindy L K Lam, Eric Y F Wan, and Tai Pong Lam.
• Department of Family Medicine & Primary Care and Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong, Hong Kong SAR. chinwy@hku.hk.
• Fam Pract. 2015 Jun 1; 32 (3): 288296288-96.

BackgroundIn Asia, the role of primary care physicians (PCPs) in mental health delivery is not clearly defined and what happens to patients following a depressive episode remains poorly understood.ObjectiveTo examine the 12-month naturalistic outcomes of depression in primary care and the impact of PCP identification.MethodsA cohort study was conducted. A total of 10179 adults were consecutively recruited from the waiting rooms of 59 PCPs across Hong Kong to complete a survey which screened for depression. Blinded doctors provided data on their diagnosis and management; 539 screened-positive and 3819 screened-negative subjects consented to telephone follow-up at 3, 6 and 12 months. Study instruments included Patient Health Questionnaire-9, Centre for Epidemiologic Studies Depression Scale 20 and Short-Form Health Survey Version 2.0 (SF-12v2) and self-reported mental health and primary care service use.Results12-month remission rate was 60.31%. PCP detection had no association with remission. Identified patients had poorer health-related quality of life (HRQOL) at baseline but a faster rate of recovery in SF-12v2 mental component scores. PCP detection was associated with greater mental health service use at 12, 26 and 52 weeks, while GP consultation rates were only increased at 12 weeks.ConclusionsOver 1 year, ~60% of depressed patients experience symptom resolution, while 40% continue to suffer a chronic or remitting course of illness. Identification of depression by a PCP does not appear to affect remission of mood symptoms at 12 months, but is associated with a faster rate of recovery of HRQOL. PCP detection raises GP consultation rates temporarily however appears to enable more patients to access mental health services over 12 months.© The Author 2015. Published by Oxford University Press.

41 keywords...

hide…