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Press '1' if you're feeling depressed


Feeling blue? Soon you may be able to call an 800 number that will help determine whether that down-in-the-dumps feeling is more than just a passing phase.

Columbia University psychiatrists have designed a new method doctors can use to screen their patients for mental disorders. The computer-based technique asks the person questions about their thoughts and feelings, sleeping habits and family relationships, runs them through a diagnostic program and faxes the results to the person's doctor.

Starting in August, many people will be able to complete the questionnaire 24 hours a day by calling an 800 number or local phone number, moving through the questions using a voice mail-type system. The system is being marketed to HMOs across the country.

Because the telephone interview can be done at home, it may encourage more people to call and report any problems they may be having, said Christina Hoven, a professor of epidemiology and psychiatry at Columbia University and the New York State Psychiatric Institute.

A phone-based system also makes access to mental-health screening easier for people with literacy or language problems, she said.

A 15-minute doctor's-office version of the diagnostic system also has been developed. After a patient completes a questionnaire at a computer terminal, a nurse or other health professional can examine the results and conduct a brief diagnostic interview -- later forwarding all information to a doctor.

The system is designed to look for relatively common disorders, such as depression, panic disorders, alcohol and drug dependence and anxiety.

Up to 35 percent of patients seen by primary-care doctors have some type of mental disorder, claims Dr. Mark Olfson, an assistant professor of clinical psychiatry at Columbia.

"About two-thirds of common problems that have no real physical cause are related to depression," said Dr. Linda Fay, a family physician in Falls Church, Va. "But then you have to convince patients that what you're saying has some legitimacy."

The new computer/telephone system could help persuade people that the problems they're having may need attention, she said.

One concern of the system's developers is that their product will work too well -- identifying so many potential mental-health problems that doctors will become overwhelmed.

"One of the things that is of great concern is that we're going to actually be identifying a great deal of psychopathology that has been unidentified to date. The question is, are we equipped to meet that demand," Dr. Hoven said.

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