Skip to main content
NCBI home page
Atencion Primaria logoLink to Atencion Primaria
. 2013 Apr 5;28(8):543–549. [Article in Spanish] doi: 10.1016/S0212-6567(01)70445-3

Depresión en la adolescencia en centros de atención primaria: importancia de un problema oculto en salud colectiva

Depression in adolescence treated at primary care centres: size of a hidden problem of general health

L dos Santos Palazzo a,*, J Umberto Béria b, F Alonso-Fernández c, E Tomasi d
PMCID: PMC7681640  PMID: 11792272

Abstract

Objectives

To investigate the prevalence of depression and its relationship to the reason for the consultation and to the medical diagnosis.

Design

Descriptive, cross-sectional design.

Setting

Primary care units of a community in Brazil.

Patients and other participants

Individuals between 13 and 19 years old, who attended 10 primary care units to consult with a non-psychiatric doctor between October 1997 and January 1998 (n = 463).

Main measurements and results

The CETDE (Alonso-Fernández, 1986) was used to measure depression, jointly with a questionnaire for evaluating social and demographic details and data pertinent to the consultation. Prevalence ran at 26.5% (95% CI: 22.6–30.4%). 99.2% cases of depression had not been identified. Complaints were spread over the somatic field (61.1%), or were sex-related (49.5%), mainly pregnancy (31.7%), especially among the cases of depression (p < 0.001). There were few psychiatric-social complaints (1.5%). Diagnoses often coincided with complaints: 59.9% somatic, 38.4% sex-related (pregnancy = 21.6%) and 1.7% psychiatric-social.

Conclusions

Adolescent depression is common in primary care, but is not usually identified. The reason for this may be the kind of depression, which is usually light or focused on just one dimension of human vitality; the doctor´s tendency to centre his/her attention on the complaint without broadening the clinical spectrum; or even because the adolescent expresses his/her emotional problems poorly, which often contributes to the depression not being diagnosed.

Key words: Adolescence, Depression, Primary care, Brazil

Bibliografía

  • 1.Murray C.J., López A.D. Alternative projections of mortality and disability by cause 2020: Global Burden of Disease Study. Lancet. 1997;349:1498–1505. doi: 10.1016/S0140-6736(96)07492-2. 24. [DOI] [PubMed] [Google Scholar]
  • 2.Marcelli D. Adolescencia y depresión: un abordaje multifocal. Masson; Barcelona: 1992. [Google Scholar]
  • 3.Weissman M. Depressed adolescents grown up. JAMA. 1999;281:1707–1713. doi: 10.1001/jama.281.18.1707. [DOI] [PubMed] [Google Scholar]
  • 4.Lewinsohn P.M., Rohde P., Seeley J.R. Psychosocial risk factors for future adolescent suicide attempts. J Consult Clin Psychology. 1994;62:297–305. doi: 10.1037//0022-006x.62.2.297. [DOI] [PubMed] [Google Scholar]
  • 5.Kandel D., Davies M. Adult sequelae of adolescent depressive symptoms. Arch Gen Psychiatry. 1986;43:255–262. doi: 10.1001/archpsyc.1986.01800030073007. [DOI] [PubMed] [Google Scholar]
  • 6.Harrington R. Adult outcomes of childhood and adolescent depression. Psiquiatric status. Arch Gen Psychiatry. 1990;47:465–473. doi: 10.1001/archpsyc.1990.01810170065010. [DOI] [PubMed] [Google Scholar]
  • 7.Alonso-Fernández F. La depresión y su diagnóstico. Nuevo modelo clínico. Labor; Barcelona: 1988. [Google Scholar]
  • 8.Bhatara V.S. Early detección of adolescent mood disorders. South Dakota Journal of Medicine. 1992;45:75–78. [PubMed] [Google Scholar]
  • 9.Troxler M.A., Grogg S.E. Guide to family practitioners for the diagnosis and treatment of depression in children and adolescents. J Amer Osteopth Assoc. 1997;97:280–285. doi: 10.7556/jaoa.1997.97.5.280. [DOI] [PubMed] [Google Scholar]
  • 10.Post D., Carr C., Weigand J. Teenagers: mental health and psychological issues. Adolesc Med. 1998;25:181–192. doi: 10.1016/s0095-4543(05)70331-6. [DOI] [PubMed] [Google Scholar]
  • 11.Capelli M. Identifying depressed and suicidal adolescents in a teen health clinic. J Adolesc Health. 1995;16:64–70. doi: 10.1016/1054-139X(94)00076-Q. [DOI] [PubMed] [Google Scholar]
  • 12.Kirmayer L.J. Somatization and the recognition of depression and ansiety in primary care. Am J Psychiatry. 1993;150:734–741. doi: 10.1176/ajp.150.5.734. [DOI] [PubMed] [Google Scholar]
  • 13.Tylee A.T. Why do general practitioners reconize major depression in one woman patient yet miss it in another? Br J Gen Pract. 1993;43:327–330. [PMC free article] [PubMed] [Google Scholar]
  • 14.Sen B. An analysis of the nature of depressive phenomena in primary health care utilising multivariate statistical techniques. Acta Psychatr Scand. 1987;76:28–32. doi: 10.1111/j.1600-0447.1987.tb02858.x. [DOI] [PubMed] [Google Scholar]
  • 15.Colino N.R., Fernández Barrero A., Martínez P.U. Utilización de la consulta de atención primaria por los adolescentes y detección de problemas de salud no demandados. Aten Primaria. 1995;16:594–600. [PubMed] [Google Scholar]
  • 16.EL-Rufae O.E.F.A., Albar A.A., AL-Dabal B.K. Identifying ansiety and depressive disorders among primary care patients: a pilot study. Acta Psychiatr Scand. 1988;77:280–282. doi: 10.1111/j.1600-0447.1988.tb05121.x. [DOI] [PubMed] [Google Scholar]
  • 17.Alonso-Fernández F. CET-DE: Cuestionario Estructural Tetra-dimensional para la Depresión (3.ª ed. revisada y ampliada) TEA, S.A; Madrid: 1995. [Google Scholar]
  • 18.Mary J.J., Williams P. A validity study of a psychiatric screening questionnaire (SRQ-20) in primary care in the city of São Paulo. Br J Psychiatry. 1986;148:23–26. doi: 10.1192/bjp.148.1.23. [DOI] [PubMed] [Google Scholar]
  • 19.Argimón Pallás J.M., Jiménez Villa J. Métodos de investigación clínica y epidemiológica. 2.a. Harcourt S.A.; Madrid: 1999. [Google Scholar]
  • 20.Ryan N.D. The clinical picture of major depression in children and adolescents. Arch Gen Psychiatry. 1987;44:854–861. doi: 10.1001/archpsyc.1987.01800220016003. [DOI] [PubMed] [Google Scholar]
  • 21.Souza Soares K.V. Sintomas depressivos em adolescentes: análise dos dados do estudo Multicêntrico de Morbidade Psiquiátrica em Áreas Metropolitanas. Revista ABP-APAL. 1994;16:11–17. [Google Scholar]
  • 22.Zwaigenbaum L. Highly somatizing young adolescents and the risk of depression. Pediatrics. 1999;103:1203–1209. doi: 10.1542/peds.103.6.1203. [DOI] [PubMed] [Google Scholar]
  • 23.Malus M. Priorities in adolescent health care: the teenager’s viewpoint. J Fam Pract. 1987;25:159–162. [PubMed] [Google Scholar]
  • 24.Blum R. Physicians assessment of deficiencies and desire for training in adolescent care. J Med Educ. 1987;62:401–407. doi: 10.1097/00001888-198705000-00005. [DOI] [PubMed] [Google Scholar]
  • 25.Iacoponi E. Metodological issues in measuring the detection of emocional disorders by primary care physicians – a review of the literature. Rev Saúde Públ S. Paulo. 1988;22:46–56. doi: 10.1590/s0034-89101988000100007. [DOI] [PubMed] [Google Scholar]
  • 26.Marks A., Fisher M., Lasker S. Adolescent medicine in pediatric practice. J Adolesc Health Care. 1990;11:149–153. doi: 10.1016/0197-0070(90)90026-x. [DOI] [PubMed] [Google Scholar]
  • 27.Goldberg D. Epidemiology of mental disorders in primary care settings. Epidemiol Rev. 1995;17:182–190. doi: 10.1093/oxfordjournals.epirev.a036174. [DOI] [PubMed] [Google Scholar]
  • 28.Kandel D., Davie M. Epidemiology of depressive mood in adolescents: an empirical study. Arch Gen Psychiatry. 1982;39:1205–1212. doi: 10.1001/archpsyc.1982.04290100065011. [DOI] [PubMed] [Google Scholar]
  • 29.Allgood-Merten B., Lewinshon P.M., Hops H. Sex differences and adolescent depression. J Abnorm Psychol. 1990;99:55–63. doi: 10.1037//0021-843x.99.1.55. [DOI] [PubMed] [Google Scholar]
  • 30.Fisher M., Marks A., Trieller K. Meeting the health care needs of suburban youth: review of a clinical service. Pediatrics. 1988;81:8–13. [PubMed] [Google Scholar]
  • 31.Colomer J., Brines J. Embarazo en la adolescencia. An Esp Pediatr. 1991;35(Supl 46):84–86. [PubMed] [Google Scholar]
  • 32.Myers K. Risk for suicidality in major depression disorders. J Am Acad Child Adolesc Psychiatry. 1991;30:86–99. doi: 10.1097/00004583-199101000-00013. [DOI] [PubMed] [Google Scholar]
  • 33.Clark D.C., Kerkhof J.M.F. Unreconized symptoms of depression. Crisis. 1994;15:2–3. [PubMed] [Google Scholar]
  • 34.Mendonza V.L. Aproximación al estudio de los perfiles situacionales de la mujer depresiva [tesis doctoral] Universidad Complutense de Madrid; Madrid: 1992. [Google Scholar]

Articles from Atencion Primaria are provided here courtesy of Elsevier

RESOURCES