Errors in Diagnosis

GPs looking for depression make more misidentifications (false positives of depression) than the number of depressions they correctly spot following an initial consultation but accuracy could improved by re-assessment of people suspected of having depression.

The study pooled 41 trials from nine countries that used robust outcome standard of a semi-structured interview to assess depression. The researchers found that GPs were able to recognize about half of people who had clinical depression and correctly reassured 80% of healthy people.

Dr Alex Mitchell of the University of Leicester said: "Imagine a typical GP who is trying to spot depression in a rural practice. He or she might see 100 people over five days. If all the people with depression came to see the GP at once, they would fill the surgery for at least half a day. However, the hard pressed GP would actually only spot half of these cases and half would be missed. On four days the GP would see people with other complaints but he or she would mistakenly diagnose up to one in five as depressed, equivalent to almost one full day of contacts. In the worst case scenario false diagnoses could outnumber true diagnoses three to one."

The researchers added: "Our results should not be interpreted as a criticism of GPs for failing to diagnose depression but rather a call for better understanding of the problems that non-specialists face."; Source: University of Leicester