Spotting patients with depression

Depression is a worldwide problem that is often undiagnosed. Many depressed patients present to GPs and a meta-analysis has compared how well GPs in different countries detect depression.

The reviewers searched for diagnostic studies with similar methodologies carried out in high-income countries. Studies relying on mood questionnaires or reviews of medical records were excluded.

There were 25 studies involving 8917 patients in the review. These included eight studies from the US, six from the Netherlands, four from Australia, four from Italy and three from the UK. The prevalence of depression varied between countries – lowest in Australia and highest in Italy.

Italian doctors had the highest diagnostic sensitivity, but Australia was not far behind (64% vs 59%). Doctors in the UK and US diagnosed less than half of the depressed patients.

Dutch doctors were best at identifying patients who were not depressed. Ruling out cases of