• Seong-Yi Baik, Barbara J Bowers, Linda Denise Oakley, and Jeffrey L Susman.
• University of Cincinnati College of Nursing, 262 Procter Hall, 3110 Vine Street, Cincinnati, OH 45221-0038, USA. seongyi.baik@uc.edu
• Ann Fam Med. 2005 Jan 1; 3 (1): 313731-7.

PurposeThe purpose of this study was to explore the responses of primary care clinicians to patients who complain of symptoms that might indicate depression, to examine the clinical strategies used by clinicians to recognize depression, and to identify the conditions that influence their ability to do so.MethodsThe grounded theory method was used for data collection and analysis. In-depth, in-person interviews were conducted with a purposeful sample of 8 clinicians. All interviews were audiotaped and transcribed.ResultsThis study identified 3 processes clinicians engage in to recognize depression-ruling out, opening the door, and recognizing the person-and 3 conditions-familiarity with the patient, general clinical experience, and time availability-that influence how each of the processes is used.ConclusionsThe likelihood of accurately diagnosing depression and the timeliness of the diagnosis are highly influenced by the conditions within which clinicians practice. Productivity expectations in primary care will continue to undermine the identification and treatment of depression if they fail to take into consideration the factors that influence such care.

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