PT  - JOURNAL ARTICLE
AU  - Chizobam Ani
AU  - Mohsen Bazargan
AU  - David Hindman
AU  - Douglas Bell
AU  - Michael Rodriguez
AU  - Richard S. Baker
TI  - Comorbid Chronic Illness and the Diagnosis and Treatment of Depression in Safety Net Primary Care Settings
AID  - 10.3122/jabfm.2009.02.080035
DP  - 2009 Mar 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 123--135
VI  - 22
IP  - 2
4099  - http://www.jabfm.org/content/22/2/123.short
4100  - http://www.jabfm.org/content/22/2/123.full
SO  - J Am Board Fam Med2009 Mar 01; 22
AB  - Objective: To estimate the impact of chronic medical conditions on depression diagnosis, treatment, and follow-up care in primary care settings.Design: This was a cross-sectional study that used interviewer-administered surveys and medical record reviews. Three hundred fifteen participants were recruited from 3 public primary care clinics. Depression diagnosis, guideline-concordant treatment, and follow-up care were the primary outcomes examined in individuals with depression alone compared with individuals with depression and chronic medical conditions measured using the Charlson Comorbidity Index (CCI).Results: Physician diagnosis of depression (32.6%), guideline-concordant depression treatment (32.7%), and guideline-concordant follow-up care (16.3%) were all low. Logistic regression analysis showed no significant difference in the likelihood of depression diagnosis, guideline-concordant treatment, or follow-up care in individuals with depression alone compared with those with both depression and chronic medical conditions. Participants with severe depression were, however, twice as likely to receive a diagnosis of depression as participants with moderate depression. In addition, participants with moderately severe and severe depression received much less appropriate follow-up care than participants with moderate depression. Among participants receiving a depression diagnosis, 74% received guideline-concordant treatment.Conclusion: Physician depression care in primary care settings is not influenced by competing demands for care for other comorbid medical conditions.