Depression in Primary Care, 2010-2018

BACKGROUND: Depression is common in primary care and significantly reduces quality of life. Our study aimed to examine the prevalence of depression in primary care visits, examine patterns of depression treatment and referral, and determine how often depression screening occurred over an 8-year timespan. METHODS: From the 2010-2018 National Ambulatory Medical Care Survey, a national probability sample of non-federal, ambulatory encounters, we identified adults being seen in a primary care clinic. We assessed the prevalence of depression screening, diagnosis, and treatment. RESULTS: During these 8 years, 13.1% of primary care encounters involved a patient with a diagnosis of depression. The prevalence of depression did not change over time. Patients were screened for depression 4.1% of the time, with screening increasing over time. Depression was more likely to be diagnosed when screening occurred (odds ratio 9.9; 95% confidence interval, 6.8-14.5%). Most patients were treated with a selective serotonin reuptake inhibitor. CONCLUSION: Depression is common in primary care, though screening was infrequent. Practices should consider instituting universal screening.