Depression in men attending a rural general practice: factors associated with prevalence of depressive symptoms and diagnosis.

BACKGROUND Doctors are less likely to diagnose depression in men than in women. Little research has been conducted to explore the underlying reasons for this in rural settings, or to compare primary care doctors' and male patients' ratings of perceived depression. AIMS To identify symptomatic and socio-demographic correlates of depression in men attending a rural practice, and to compare and contrast general practitioners' and patients' assessments of depression. METHOD All male patients of working age attending a rural general practice over a 12-month period were invited to participate. RESULTS Men reporting recent "chest pain" or "feeling tired/little energy", expressing low job enjoyment or with a previous diagnosis of depression were more likely to be scored above threshold on the Hospital Anxiety and Depression Scale-Depression sub-scale. There was little agreement between the doctors and their male patients about the degree of perceived depression. CONCLUSIONS Educational interventions aimed at addressing the diagnosis of depression in men should take greater account of factors within a particular social setting.