Background. Screening surveys of depressive symptoms were conducted among primary care
patients at six sites in different countries. The LIDO Study was designed to assess quality of life and
economic correlates of depression and its treatment in culturally diverse primary health care
settings. This paper describes: (1) the association between depressive symptoms and functional
status, global health-related quality of life (QoL), and use of general health services across different
cultural settings; and (2) among subjects with depressive symptoms, the factors associated with
recent treatment for depression.
Methods. Subjects aged 18 to 75 were recruited from participating primary care facilities in Be'er
Sheva (Israel), Porto Alegre (Brazil), Melbourne (Australia), Barcelona (Spain), St Petersburg
(Russian Federation) and Seattle (USA). Depressive symptoms were measured using the CES-D.
Also administered were the SF-12, global questions on QoL, selected demographic and social
measures, and questions on recent treatment for depression, use of health care services, and lost
Results. A total of 18489 patients were screened, of whom 37% overall (range 24–55%) scored
[ges ]16 on the CES-D and 28% (range 17–42%) scored [ges ]20. Overall, 13% reported current
treatment for depression (range 4 to 23%). Patients with higher depressive symptom scores had
worse health, functional status, QoL, and greater use of health services across all sites. Among those
with a CES-D score [ges ]16, subjects reporting treatment for depression were more likely than those
reporting no treatment to be dissatisfied with their health (except in St Petersburg), and to have
higher depressive symptom scores.
Conclusions. Higher depressive symptom scores in primary care patients were consistently
associated with poorer health, functional status and QoL, and increased health care use, but not
with demographic variables. The likelihood of treatment for depression was associated with
perceptions of health, as well as severity of the depression.