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Discovering Depression in Medical Patients: Reasonable Expectations

Kurt Kroenke, MD
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Uniformed Services University of the Health Sciences, Bethesda, MD 20814 Disclaimer: The opinions contained in this article are those of the author and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense. Requests for Reprints: Kurt Kroenke, MD, Department of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;126(6):463-465. doi:10.7326/0003-4819-126-6-199703150-00008
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One fact has been cited almost tiresomely: Primary care clinicians fail to diagnose depression in half of their patients who have the condition. When depression is detected, clinicians provide adequate treatment only half of the time [14]. Because 5% to 10% of medical outpatients (and even more inpatients) have major depression, this indictment is alarming. However, it is also a bit too facile. It ignores the barriers that make detection of depression particularly challenging in the medical setting: time, somatization, stigmatization, reimbursement, and comorbid medical conditions.

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