UNAIDED GENERAL PRACTITIONERS’ CLINICAL DIAGNOSIS IN EVALUATION OF DEPRESSIVE PATIENTS: A Pilot Study

Background: In this study we wished to determine the diagnostic accuracy of unaided general practitioners’ (GPs’) clinical diagnosis in the evaluation of depression in depressed patients under their care compared with the Beck Depression Inventory II (BDI-II). Subjects and methods: From 17,000 patients in 10 GPs’ offices as representative sample in the city of Zagreb, 5100 patients from three GPs’ offices were selected. The sample consisted of 53 out of 76 depressed patients with a diagnosis of Depressive episode (F32) or Recurrent depressive disorder (F33) classified according to ICD-10 and assessed by review of the GP’s standardized medical records. Cross-sectional investigation was performed during February 2008. GPs classified depressed patients as either nondepressed without therapy, nondepressed with therapy or depressed with therapy. Within a two-week period, the unaided GPs' diagnosis was compared with BDI-II performed by psychologists unfamiliar with the GPs’ assessment. Based on the GP vs. BDI-II comparison, patients were classified as either positive, false positive, false negative or negative. Sensitivity, specificity, PPV, and NPV associated with physician identification of depression were calculated by standard methods. Results: Depressiveness was found by BD-II in the group ‘depressed with therapy’ (24.39±10.91). ANOVA found a significant difference in BDI-II means between the outcome groups (P