Depression: Inside and Outside the Hospital Setting

Abstract

Twenty general practice patients selected for treatment with tricyclic antidepressants were matched with an equal number of psychiatric in-patients who had been admitted to hospital for depressive illnesses. In order to assess their depressive status, the Levine-Pilowsky (LPD) questionnaire was administered to both groups. It was found that although patients from each setting reported the same degree of depressive severity, the pattern of their LPD responses differed significantly. Twice as many hospital patients were assigned to either Class A (‘non-endogenous depression’) or Class B (‘endogenous depression) compared to the general practice patients, most of whom were classified as Class C (‘non depressed’). These results indicate the importance of distinguishing between depressive severity and depressive classification when comparing patients encountered outside the hospital setting with those who are in-patients.

Symptom profiles of depression among general medical service users compared with speciality mental health service users

“…Most British studies and some American studies on depression support this perspective. Investigators have found that depressive patients seen in the primary-care sector have briefer episodes, express changes in mood less frequently, and more often present in somatic terms than depressed patients in the psychiatric sector (Goldberg & Blackwell, 1970 ;Fahy, 1974 ;Pilowsky & Spence, 1978 ;Sireling et al 1985 ;Emmons et al 1987). Williamson & Yates (1989) reported that depressed medical patients' chief complaints were more somatic, obscure and less psychologically focused when compared with psychiatric patients.…”