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Barry H. Guze, MD; Daniel X. Freedman, MD

JAMA. 1991;265(23):3164-3165.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

As in all of medicine, we are methodically revising clinical impressions with systematic clinical research. From psychiatric epidemiology, recent reports target mood disorders. The Medical Outcomes Study¹ reported on patients from varied practice settings, documenting significant impairments and high use of health care resources not only in the diagnosable depressive disorders but in the "subsyndromal"—patients with countable symptoms that do not reach a diagnostic threshold. In terms of functional impairments and the performance of the tasks of daily living, only chronic cardiac disease was comparable. When depressive symptoms occur with medical disorders, impairment is even more severe. Mixtures of anxiety and depression encountered in primary care often do not yield to formal diagnostic criteria.^2-4 Yet nonpsychiatric practitioners initially encounter the majority of the fiscally and socially costly depressive disorders; useful criteria for their recognition and guidelines for their treatment or referral have some public health urgency.

Drawing from . . . [Full Text PDF of this Article]

Author Affiliations
UCLA School of Medicine, Los Angeles, Calif

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