Depression in a family practice in Japan: Doctor shopping and patient complaints

Background: Depression is commonly encountered in general practice. However, illness behaviour and subjective symptoms of depression are not well described in Japan. The purpose of this study was to examine the association between depression and clinical clues, such as doctor shopping (frequency of consultations), severity, and duration of patient complaints. Methods: A cross-sectional study of consecutive 162 first visit patients (54 males, 108 females) was performed during 1-year (October 1, 2001 - September 30, 2002) of a family practice. The Mini-International Neuropsychiatric Interview obtained data on major depressive disorder at the family practice, while the doctor shopping, severity, and duration of subjective symptoms were obtained on our original questionnaire. Results: Six in 162(3.7%) patients fulfilled the diagnostic criteria of major depressive episode. Compared with the other 156 patients, doctor shopping was not a significant factor in first visit patients with depression (P value = 0.169), but severity (P=0.003) and duration (P=0.022) of symptoms were significant for those with depression in primary care. Conclusion: We found that the severity and duration of any subjective symptoms were significantly related to consulting a doctor by the patients with depression in a family practice in Japan.