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Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network

BACKGROUND: This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong. METHODS: A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PH...

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Autores principales: Chin, Weng Yee, Chan, Kit TY, Lam, Cindy LK, Wong, Samuel YS, Fong, Daniel YT, Lo, Yvonne YC, Lam, Tai Pong, Chiu, Billy CF
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937039/
https://www.ncbi.nlm.nih.gov/pubmed/24521526
http://dx.doi.org/10.1186/1471-2296-15-30
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author Chin, Weng Yee
Chan, Kit TY
Lam, Cindy LK
Wong, Samuel YS
Fong, Daniel YT
Lo, Yvonne YC
Lam, Tai Pong
Chiu, Billy CF
author_facet Chin, Weng Yee
Chan, Kit TY
Lam, Cindy LK
Wong, Samuel YS
Fong, Daniel YT
Lo, Yvonne YC
Lam, Tai Pong
Chiu, Billy CF
author_sort Chin, Weng Yee
collection PubMed
description BACKGROUND: This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong. METHODS: A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PHQ-9 scores reported whether they thought their patients had depression and their management. RESULTS: 10,179 patients completed the survey (response rate 81%). The prevalence of PHQ-9 positive screening was 10.7% (95% CI: 9.7%-11.7%). Using multivariate analysis, risk factors for being PHQ-9 positive included: being female; aged ≤34 years; being unmarried; unemployed, a student or a homemaker; having a monthly household income < HKD$30,000 (USD$3,800); being a current smoker; having no regular exercise; consulted a doctor or Chinese medical practitioner within the last month; having ≥ two co-morbidities; having a family history of mental illness; and having a past history of depression or other mental illness. Overall, 23.1% of patients who screened PHQ-9 positive received a diagnosis of depression by the doctor. Predictors for receiving a diagnosis of depression included: having higher PHQ-9 scores; a past history of depression or other mental health problem; being female; aged ≥35 years; being retired or a homemaker; being non-Chinese; having no regular exercise; consulted a doctor within the last month; having a family history of mental health problems; and consulted a doctor in private practice. In patients diagnosed with depression, 43% were prescribed antidepressants, 11% were prescribed benzodiazepines, 42% were provided with counseling and 9% were referred, most commonly to a counselor. CONCLUSION: About one in ten primary care patients screen positive for depression, of which doctors diagnose depression in approximately one in four. At greatest risk for depression are patients with a past history of depression, who are unemployed, or who have multiple illnesses. Patients most likely to receive a diagnosis of depression by a doctor are those with a past history of depression or who have severe symptoms of depression. Chinese patients are half as likely to be diagnosed with depression as non-Chinese patients. Over half of all patients diagnosed with depression are treated with medications.
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spelling pubmed-39370392014-02-28 Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network Chin, Weng Yee Chan, Kit TY Lam, Cindy LK Wong, Samuel YS Fong, Daniel YT Lo, Yvonne YC Lam, Tai Pong Chiu, Billy CF BMC Fam Pract Research Article BACKGROUND: This study aimed to examine the prevalence, risk factors, detection rates and management of primary care depression in Hong Kong. METHODS: A cross-sectional survey containing the PHQ-9 instrument was conducted on waiting room patients of 59 primary care doctors. Doctors blinded to the PHQ-9 scores reported whether they thought their patients had depression and their management. RESULTS: 10,179 patients completed the survey (response rate 81%). The prevalence of PHQ-9 positive screening was 10.7% (95% CI: 9.7%-11.7%). Using multivariate analysis, risk factors for being PHQ-9 positive included: being female; aged ≤34 years; being unmarried; unemployed, a student or a homemaker; having a monthly household income < HKD$30,000 (USD$3,800); being a current smoker; having no regular exercise; consulted a doctor or Chinese medical practitioner within the last month; having ≥ two co-morbidities; having a family history of mental illness; and having a past history of depression or other mental illness. Overall, 23.1% of patients who screened PHQ-9 positive received a diagnosis of depression by the doctor. Predictors for receiving a diagnosis of depression included: having higher PHQ-9 scores; a past history of depression or other mental health problem; being female; aged ≥35 years; being retired or a homemaker; being non-Chinese; having no regular exercise; consulted a doctor within the last month; having a family history of mental health problems; and consulted a doctor in private practice. In patients diagnosed with depression, 43% were prescribed antidepressants, 11% were prescribed benzodiazepines, 42% were provided with counseling and 9% were referred, most commonly to a counselor. CONCLUSION: About one in ten primary care patients screen positive for depression, of which doctors diagnose depression in approximately one in four. At greatest risk for depression are patients with a past history of depression, who are unemployed, or who have multiple illnesses. Patients most likely to receive a diagnosis of depression by a doctor are those with a past history of depression or who have severe symptoms of depression. Chinese patients are half as likely to be diagnosed with depression as non-Chinese patients. Over half of all patients diagnosed with depression are treated with medications. BioMed Central 2014-02-12 /pmc/articles/PMC3937039/ /pubmed/24521526 http://dx.doi.org/10.1186/1471-2296-15-30 Text en Copyright © 2014 Chin et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chin, Weng Yee
Chan, Kit TY
Lam, Cindy LK
Wong, Samuel YS
Fong, Daniel YT
Lo, Yvonne YC
Lam, Tai Pong
Chiu, Billy CF
Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
title Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
title_full Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
title_fullStr Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
title_full_unstemmed Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
title_short Detection and management of depression in adult primary care patients in Hong Kong: a cross-sectional survey conducted by a primary care practice-based research network
title_sort detection and management of depression in adult primary care patients in hong kong: a cross-sectional survey conducted by a primary care practice-based research network
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937039/
https://www.ncbi.nlm.nih.gov/pubmed/24521526
http://dx.doi.org/10.1186/1471-2296-15-30
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