Purpose The relationship between chronic disease and depression is not well characterized in low-income patient populations. In this study, we examine the medical records of over 300 patients to test the hypothesis that patients with two or more chronic health conditions exhibit a higher prevalence of clinical depression than patients with one chronic health condition.
Methods A 1-page, multiple-items chart abstraction instrument was used to collect data from 336 medical records of patients who were diagnosed with “major depression” during a 7-month period from June 2005 to January 2006 at two large ‘safety net’ clinics in Los Angeles County. The abstraction instrument collected such information as patient demographics, chronic disease diagnoses, and depression treatment plans. Statistical analyses were performed using the Stata 9.2 statistical software.
Results There was no statistically significant association between the number of chronic conditions that a patient has and whether he/she received a diagnosis of clinical depression as documented in the chart. The best predictors of receiving a depression diagnosis were psychosocial stressors such as a death in the family (OR 3.71, p = .122, 95% CI 0.70, 19.59) and anxiety disorders (OR 9.07, p < .001, 95% CI 3.44, 23.92).
Conclusion Findings suggest that low-income patients with two or more chronic conditions are less likely to receive a diagnosis of depression and care for this condition. Psychosocial factors such as emotional stress or anxiety disorders were better predictors of whether or not a health care provider screened for and provided treatment for depression.
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