Prevalence of depression symptoms and associated socio-demographic factors in primary health care patients.

Background: Depression is a growing public health problem still under-recognised in primary care settings. By focusing primarily on somatic complaints and diseases, general practitioners often fail to identify an underlying mental disorder. The aim of this study was to assess the prevalence of patients with unrecognised depression symptoms in general practice and identify associated socio-demographic factors.

Subjects And Methods: The study included 769 patients without previous psychiatric disorder who attended their primary care physicians in the Health Centre Zagreb - Zapad in January 2011. Data on patients' age, sex, level of education, marital and employment status were collected. All participants completed The Zung Self-Rating Depression Scale.

Results: Among the 25.5% of participants whose Zung score was outside the normal range, 19.38% were mildly, 4.64% moderately, and 0.91% severely depressed. Statistically significant differences were observed among groups defined according to level of education, employment and marital status (p<0.001). Lower Zung scores were found in individuals with a higher level of education, who were unmarried, employed or still undergoing education. Multivariate logistic regression model revealed that older age (p<0.001), unemployment (p=0.001) or unmarried status (p=0.025) were significant predictors of depression symptoms.

Conclusions: The study revealed a high prevalence of depression symptoms among primary care patients who had not been previously suspected to have any psychiatric co-morbidity. Awareness of depression symptoms and disorders should be raised among general practitioners, focusing on older, unemployed and unmarried people.