Study indicates doctors need training to spot depression

January 11, 2000
Web posted at: 9:39 p.m. EST (0239 GMT)

In this story: Depression takes toll on workers, employers 'The HMO's are under a lot of pressure ...' RELATED STORIES, SITES

From Health Correspondent Holly Firfer

(CNN) -- Are you depressed? Would your primary care doctor know it if you were depressed?

According to a study in this week's Journal of the American Medical Association, depression is expected to be the second leading cause of disability worldwide in the next decade.

Depression is treatable. But researchers for the study say primary care physicians, the doctors that patients go to most often, are not always trained to spot the warning signs.

"There are so many things on a doctor's mind," said Dr. Kenneth Wells, one of the researchers. "They have to think of the hypertension, the diabetes, the cold ... and depression may not come up."

But the study indicates that when primary care physicians get training to spot depression during routine patient screening, patients improve and keep their jobs longer.

	ARE YOU DEPRESSED?
Use the menu below to view signs of depression Select here: Emotions Appetite/weight Sleep Anger Outlook Libido Self-esteem Concentration Anxiety Restlessness Muted affect Suicide (Source: WebMD)

Depression takes toll on workers, employers

Tom Gossard knows firsthand that depression can be a costly illness.

"I was beginning to experience problems at work -- inability to concentrate, inability to complete projects as I had always done," said Gossard. "I had always been a very astute and a good worker, although I hadn't been able to hold down very many full-time jobs."

Earlier studies have shown that nearly 20 percent of all primary care patients in the United States have significant depression symptoms. About 5 percent of these patients are clinically depressed, and only about a quarter of those with severe cases receive treatment.

"I began to feel very morose and despondent about myself and about my future," said Gossard. "I began also to feel increasing episodes of anxiety that went along with that sense of foreboding."

Researchers say that if depression is properly diagnosed and treated, patients like Gossard are able to stay gainfully employed.

"The first step is to really know what depression is and recognize its diverse forms and then be able to work with patients to understand," said Wells. "It is not like depression is a spot on the skin. You can't just know somehow it is there. You have to ask questions -- and spend time with the patient asking about symptoms."

'The HMO's are under a lot of pressure ...'

But time is often in short supply for many primary care physicians.

"The HMO's are under a lot of pressure from payers, and the payers often set the rules," said Dr. Richard Frank with Harvard University. "To do a better job on the depression front, what set of rules do we need to ... make the job easier to accomplish and to therefore get the outcome these types of studies promise."

But if doctors can be taught new tools for diagnosing depression and are given the time to use them, both Wells and Frank say, it could benefit employers, employees -- and ultimately society -- if workers with depression get the help they need to stay on the job.