The present study was undertaken to examine the utility of the Center for Epidemiological Studies-Depression (CES-D) scale and the Beck Depression Inventory (BDI) as screening instruments for primary care clinic patients. We examined: 1) patients' willingness to complete the scales; 2) the level of agreement between the screening instruments and DSM-III diagnosis of Major Depressive Episode, based on the NIMH Diagnostic Interview Schedule (DIS); 3) the effect on detection rates of raising the cut-off score for each depression screen; and 4) the factor structure of the CES-D in our primary care sample versus findings from general population studies. The CES-D and BDI performed comparably as depression screening instruments. Both produced too many false positives when standard (low) cut-off scores were applied. However, when straight cut-off scores were used, results suggested that either the CES-D or BDI might assist physicians in reliably detecting depressed patients, without an overload of false positives. Comparison of our findings with those from other studies suggest that depression screening instruments may be particularly helpful with older primary care patients. The CES-D factor analysis highlights the need to look more closely at the relevance of positive affect to the detection, diagnosis, and treatment of depressive disorders in primary care practices.

Previous research has suggested that social support may act as a buffer against stress or in other ways may affect physiological adjustment, health, longevity, and sense of well‐being. Perceptions of social support in persons newly diagnosed with Acquired Immune Deficiency Syndrome (AIDS) and AIDS‐related Complex (ARC) were examined as a part of an ongoing longitudinal study. Social support was examined in terms of emotionally‐sustaining and problem‐solving types of help, based on Gottlieb's content analysis of informal helping behaviors. Representative examples of each of the four major categories of help were assessed in terms of their perceived desirability, availability, frequency of use, and usefulness if used. These social support data were then examined in relation to other behavioral, cognitive, affective, and medical indices. For persons with AIDS only, increased physical distress was associated with perceiving less availability of support. For both persons with AIDS and ARC, the more available social support was perceived to be, the less hopelessness and depression were reported. While all types of help were rated as desirable by both persons with AIDS and ARC, emotionally‐sustaining types of help were rated as more desirable, more available, more frequently used, and more useful when used than were problem‐solving types of help. Social support measures were most consistently and strongly correlated with the Commitment subscale of Kobasa's Hardiness Scale.

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