Failure to Recognize Depression in Primary Care: Issues and Challenges

Depression is highly prevalent in the United States, affecting approximately 18.8 million adults, or about 9.5% of the U.S. population aged 18 years and older in a given year.1 Depression is particularly prevalent in primary care patients with prevalence rates of 10% or greater.2 Depression is a leading cause of disability, workplace absenteeism, diminished or lost productivity, and increased use of health care resources.3,4 Depression is associated with decreased quality of life5 and increased health care cost.6 There is also fairly consistent evidence that depression is associated with increased mortality across all age groups7–9 and that both major and minor depression are associated with increased mortality.10 Thus, depression has major public health implications.