Skip to main content
NCBI home page
Atencion Primaria logoLink to Atencion Primaria
editorial
. 2013 Apr 5;27(9):623–628. [Article in Spanish] doi: 10.1016/S0212-6567(01)78870-1

Prevalencia y características de la depresión mayor y la distimia en atención primaria

Prevalence and characteristics of major depression and dysthymia in primary care

E Aragonès Benaiges 1,*, MA Gutiérrez Pérez 1, M Pino Fortuny 1, C Lucena Luque 1, J Cervera Virgili 1, I Garreta Estrada 1
PMCID: PMC7688596  PMID: 11412553

Abstract

Objective

To find the prevalence and characteristics of depressive disorders in patients consulting in primary care.

Design

Cross-sectional descriptive study. Two stages: screening, then structured psychiatric interview.

Setting

Eight clinics at four primary care centres.

Patients and methods

A sample of 350 consecutive patients aged between 18 and 70 filled out Zung's Self-Rating Depression Scale (SDS). The diagnoses of major depressive episode and dysthymia for the 138 with positive result and the 67 with negative result were investigated through the Structured Clinical Interview for DSM-IV Axis I Disorders.

Measurements and main results

We found a weighted prevalence of 14.7% (95% CI: 10.7-18.7) for major depression and 4.6% (95% CI: 2.4-6.8) for dysthymia. Mean score on the SDS was 65.6 (SD 11.6) in the group with major depression and 63.3 (SD 8.7) in the group with dysthymia. Mean score in the not-depressed group was 44.2 (SD 8.7), lower than the scores for both groups with depression (p < 0.0001). Being female distinguished the depressed groups from the not-depressed group. Lower educational level and the amount of over-users distinguished the group with major depression from the not-depressed group. The symptom profiles were virtually identical for the two depressed groups, whereas the frequency of occurrence of most of the symptoms explored differed significantly between those with and without depression.

Conclusions

Prevalence of major depression and dysthymia are high in primary care patients in our area. Both disorders have common characteristics of demographic variables and symptom profile.

Key words: Depressive disorder, Dysthymic disorder, Primary health care, Prevalence

Bibliografía

  • 1.Goldberg D., Huxley P. Common mental disorders: a bio-social model. Tavistock/Routledge; Londres: 1992. [Google Scholar]
  • 2.Vázquez-Barquero J.L., Herrera Castanedo S., Artal J.A., Gaite L., Cuesta Núñez M.J., Goldberg D. Factores implicados en las «rutas asistenciales » en salud mental. Actas Luso-Esp Neurol Psiquiatr. 1993;21:189–203. [PubMed] [Google Scholar]
  • 3.Chocrón Bentata L., Vilalta Franch J., Legazpi Rodríguez I., Auquer K., Franch L. Prevalencia de psicopatología en un centro de atención primaria. Aten Primaria. 1995;16:586–590. y 592-593. [PubMed] [Google Scholar]
  • 4.Vázquez-Barquero J.L., García J., Artal Simón J., Iglesias C., Montejo J., Herrán A. Mental health in primary care. An epidemiological study of morbidity and use of health resources. Br J Psychiatry. 1997;170:529–535. doi: 10.1192/bjp.170.6.529. [DOI] [PubMed] [Google Scholar]
  • 5.Baca E., Sáiz J., Agüera L.F., Caballero L., Fernández-Liria A., Ramos Brieva J.A. Prevalencia de los trastornos psiquiátricos en atención primaria usando el cuestionario PRIME-MD. Aten Primaria. 1999;23:275–279. [PubMed] [Google Scholar]
  • 6.Wohlfarth T.D., Van Den Brink W., Ormel J., Koeter M.W.J., Oldehinkel A.J. The relationship between social dysfunctioning and psychopatology among primary care attenders. Br J Psychiatry. 1993;163:37–44. doi: 10.1192/bjp.163.1.37. [DOI] [PubMed] [Google Scholar]
  • 7.Ormel J., Von Korff M., Ustun T.B., Pini S., Korten A., Oldehinkel T. Common mental disorders and disability across cultures. Results from the WHO Collaborative Study on Psychological Problems in General Health Care. JAMA. 1994;272:1741–1748. doi: 10.1001/jama.272.22.1741. [DOI] [PubMed] [Google Scholar]
  • 8.Ormel J., Tiemens B. Recognition and treatment of mental illness in primary care: towards a better understanding of a multifaceted problem. Gen Hosp Psychiatry. 1995;17:160–164. doi: 10.1016/0163-8343(95)00022-j. [DOI] [PubMed] [Google Scholar]
  • 9.Schwenk T.L., Coyne J.C., Fechner-Bates S. Differences between detected and undetected patients in primary care and depressed psychiatric patients. Gen Hosp Psychiatry. 1996;18:407–415. doi: 10.1016/s0163-8343(96)00062-x. [DOI] [PubMed] [Google Scholar]
  • 10.Vázquez-Barquero J.L. Los estudios comunitarios de salud mental: su diseño y ejecución. In: González de Rivera J.L., Rodríguez F., Sierra A., editors. El método epidemiológico en salud mental. Masson; Barcelona: 1993. [Google Scholar]
  • 11.Coyne J.C., Fechner-Bates S., Schwenk T.L. Prevalence, nature, and comorbidity of depressive disorders in primary care. Gen Hosp Psychiatry. 1994;16:267–276. doi: 10.1016/0163-8343(94)90006-x. [DOI] [PubMed] [Google Scholar]
  • 12.Zung W.W.K. A self-rating depression scale. Arch Gen Psychiatry. 1965;12:63–70. doi: 10.1001/archpsyc.1965.01720310065008. [DOI] [PubMed] [Google Scholar]
  • 13.Conde V., Esteban Chamorro T. Revisión crítica de dos adaptaciones castellanas de la «Self-Rating Depression Scale» (SDS) de Zung. Arch Neurobiol Madr. 1973;36:375–392. [PubMed] [Google Scholar]
  • 14.First M.B., Spitzer R.L., Gibbon M., Williams J.B.W. Masson; Barcelona: 1999. Entrevista clínica estructurada para los trastornos del eje I del DSM-IV (versión clínica) SCID-I. [Google Scholar]
  • 15.Pickles A., Dunn G., Vázquez-Barquero J.L. Screening for stratification in two-phase («two-stage») epidemiological surveys. Stat Meth Med Res. 1995;4:73–89. doi: 10.1177/096228029500400106. [DOI] [PubMed] [Google Scholar]
  • 16.Gardner S.B., Winter P.B., Gardner M.J. compiladores. Confidence interoal analysis. In: Gardner M.J., Altman D.G., editors. Statistics with confidence. British Medical Journal; Londres: 1989. [Google Scholar]
  • 17.Kessler R.C., Little R.J.A., Groves R.M. Advances in strategies for minimizing and adjusting for survey nonresponse. Epidemiologic Rev. 1995;17:192–204. doi: 10.1093/oxfordjournals.epirev.a036176. [DOI] [PubMed] [Google Scholar]
  • 18.Gérvas J.J., Pérez Fernández M.M., García Sagredo P., Abraira V. Utilización de servicios sanitarios: pacientes y visitas. Aten Primaria. 1990;7:346–348. [PubMed] [Google Scholar]
  • 19.García Olmos L.M., Pérez Fernández M.M., Bassolo Abad A., Abraira V., Gérvas J.J. Estudios de morbididad ambulatoria: ¿qué muestra elegir? Aten Primaria. 1987;4:136–139. [Google Scholar]
  • 20.Üstün T.B., Sartorius N., editors. Mental illness in general health care: an international study. John Wiley; Chichester: 1995. [Google Scholar]
  • 21.Gater R., Tansella M., Korten A., Tiemens B.G., Mavreas V.G., Olatawura M.O. Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings. Arch Gen Psichiatry. 1998;55:405–413. doi: 10.1001/archpsyc.55.5.405. [DOI] [PubMed] [Google Scholar]
  • 22.Burvill P.W. Recent progress in the epidemiology of major depression. Epidemiologic Rev. 1995;17:21–31. doi: 10.1093/oxfordjournals.epirev.a036178. [DOI] [PubMed] [Google Scholar]
  • 23.Zung W.W.K., Broadhead W.E., Roth M.E. Prevalence of depressive symptoms in primary care. J Fam Pract. 1993;37:337–344. [PubMed] [Google Scholar]
  • 24.Rowe M.G., Fleming M.F., Barry K.L., Manwell L.B., Kropp S. Correlates of depression in primary care. J Fam Pract. 1995;41:551–558. [PubMed] [Google Scholar]
  • 25.Lecrubier Y., Weiller E. Características, reconocimiento y tratamiento de los distímicos en la asistencia primaria. Eur Psychiatry (ed esp.) 1999;6:49–54. [publicado originalmente en Eur Psychiatry 1998; 13: 198-202] [Google Scholar]
  • 26.Judd L.L., Akiskal H.S., Maser J.D., Zeller P.J., Endicott J., Coryell W. A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry. 1998;55:694–700. doi: 10.1001/archpsyc.55.8.694. [DOI] [PubMed] [Google Scholar]
  • 27.Angst J., Sellaro R., Merikangas K.R. Depressive spectrum diagnoses. Compr Psychiatry. 2000;41(Supl 1):39–47. doi: 10.1016/s0010-440x(00)80007-3. [DOI] [PubMed] [Google Scholar]

Articles from Atencion Primaria are provided here courtesy of Elsevier

RESOURCES