Who is identified when screening for depression is undertaken in general practice? Baseline findings from the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) longitudinal study

Jane M Gunn, Gail P Gilchrist, Patty Chondros, Melina Ramp, Kelsey L Hegarty, Grant A Blashki, Dimity C Pond, Mike Kyrios and Helen E Herrman
Med J Aust 2008; 188 (12): 119.


Objectives: To report the baseline characteristics of the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) study cohort and discuss the implications for depression care in general practice.

Design: A prospective longitudinal study beginning in January 2005.

Participants and setting: Adult patients with depressive symptoms identified via screening with the Center for Epidemiologic Studies Depression Scale (CES-D ≥ 16) in 30 randomly selected Victorian general practices.

Main outcome measure: Depression status on the Patient Health Questionnaire (PHQ).

Results: 789 patients form the cohort (71% women). At baseline, 47% were married, 21% lived alone, 36% received a pension or benefit, 15% were unable to work, 23% reported hazardous drinking, 32% were smokers, 39% used antidepressants and 19% used sedatives. 27% satisfied criteria for current major depressive syndrome (MDS) on the PHQ, while 52% had “persistent” depressive symptoms, and 22% had “transient” depressive symptoms, lasting at most a few weeks. Of those satisfying criteria for MDS, 49% were also classified with an anxiety syndrome, 40% reported childhood sexual abuse, 57% reported childhood physical abuse, 42% had at some time been afraid of their partner, and 72% reported a chronic physical condition; 84% were receiving mental health care (either taking antidepressants or seeing a health practitioner specifically for mental health care) compared with 66% of those with persistent depressive symptoms and 57% with transient depressive symptoms.

Conclusion: This method of screening for depressive symptoms in general practice identifies a group of patients with substantial multiple comorbidities — psychiatric, physical and social problems coexist with depressive symptoms, raising challenges for the management of depression in general practice.

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  • Jane M Gunn1
  • Gail P Gilchrist2
  • Patty Chondros1
  • Melina Ramp1
  • Kelsey L Hegarty1
  • Grant A Blashki1
  • Dimity C Pond3
  • Mike Kyrios4
  • Helen E Herrman5

  • 1 Primary Care Research Unit, Department of General Practice, University of Melbourne, Melbourne, VIC.
  • 2 Addiction and Substance-Related Disorder Research Group, Municipal Institute of Medical Research, Barcelona, Spain.
  • 3 Discipline of General Practice, University of Newcastle, Newcastle, NSW.
  • 4 Swin-PsyCHE Research Unit, Department of Psychology, Swinburne University of Technology, Melbourne, VIC.
  • 5 ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Melbourne, VIC.



The diamond study was funded by the National Health and Medical Research Council (ID 299869 & 454463) and the Victorian Centre for Excellence in Depression and Related Disorders, an initiative between beyondblue and the Victorian Government. Neither funding body had a role in study design; the collection, analysis, and interpretation of data; the writing of the manuscript; or the decision to submit this manuscript for publication. We acknowledge the 30 dedicated GPs, their patients and practice staff for making this research possible. We thank the diamond project team, including the associate investigators and researchers involved in the study: Ms Darshini Ayton, Ms Vanessa Madden, Dr David Pierce, Ms Maria Potiriadis, Dr Lena Sanci, Dr Jane Sims, Ms Donna Southern and the casual research staff.

Competing interests:

None identified.

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