Effective intervention models for depressed patients in primary care settings have been developed in other countries. In Japan, a general internist has an important role in primary care. However,there is little information on the prevalence of depression and the rate of its recognition by general internists in Japan. The present study surveyed these data in a general internal medicine outpatient clinic in a Japanese rural hospital. Results showed the prevalence of depression to be relatively high. Most depressed patients were recognized by physicians as having a mental disorder, but only a few were diagnosed as having a mood disorder. Despite a high prevalence of depression, physicians did not recognize it. Development of an optimized model to screen and introduce appropriate care for depressed patients is needed.