• Jane M Gunn, Gail P Gilchrist, Patty Chondros, Melina Ramp, Kelsey L Hegarty, Grant A Blashki, Dimity C Pond, Mike Kyrios, and Helen E Herrman.
• Primary Care Research Unit, Department of General Practice, University of Melbourne, Melbourne, VIC, Australia. j.gunn@unimelb.edu.au
• Med. J. Aust. 2008 Jun 16; 188 (S12): S119-25.

ObjectivesTo report the baseline characteristics of the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) study cohort and discuss the implications for depression care in general practice.DesignA prospective longitudinal study beginning in January 2005.Participants And SettingAdult patients with depressive symptoms identified via screening with the Center for Epidemiologic Studies Depression Scale (CES-D > or = 16) in 30 randomly selected Victorian general practices.Main Outcome MeasureDepression status on the Patient Health Questionnaire (PHQ).Results789 patients form the cohort (71% women). At baseline, 47% were married, 21% lived alone, 36% received a pension or benefit, 15% were unable to work, 23% reported hazardous drinking, 32% were smokers, 39% used antidepressants and 19% used sedatives. 27% satisfied criteria for current major depressive syndrome (MDS) on the PHQ, while 52% had "persistent" depressive symptoms, and 22% had "transient" depressive symptoms, lasting at most a few weeks. Of those satisfying criteria for MDS, 49% were also classified with an anxiety syndrome, 40% reported childhood sexual abuse, 57% reported childhood physical abuse, 42% had at some time been afraid of their partner, and 72% reported a chronic physical condition; 84% were receiving mental health care (either taking antidepressants or seeing a health practitioner specifically for mental health care) compared with 66% of those with persistent depressive symptoms and 57% with transient depressive symptoms.ConclusionThis method of screening for depressive symptoms in general practice identifies a group of patients with substantial multiple comorbidities -- psychiatric, physical and social problems coexist with depressive symptoms, raising challenges for the management of depression in general practice.

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