The underrecognition and undertreatment of depression:
what is the breadth
and depth of the problem?
by
Davidson JR, Meltzer-Brody SE
Department of Psychiatry and Behavioral Science,
Duke University Medical
Center, Durham, NC 27710, USA.
J Clin Psychiatry 1999; 60 Suppl 7:4-9; discussion 10-1
ABSTRACT
Currently, 1 in 6 of the population will, at some point during their lives,
suffer from major depression. By the year 2020, it has been estimated that major
depression will be the second most important cause of disability worldwide.
Major depression is associated not only with significant morbidity, but with
comorbid chronic illnesses and lost productivity because of excess mortality and
morbidity. The most important reason for the recognition and adequate treatment
of depression is that symptoms can be effectively controlled. Despite this,
patients are frequently neither recognized nor treated adequately.
Underdiagnosis and undertreatment of major depression can be associated with
factors relating to patients, their physicians, and the health care systems that
provide their care. The treatment of depressed patients with appropriate agents,
at appropriate doses, for appropriate periods of time, and incorporating
appropriate nonpharmacologic strategies, is cost-effective. Since much of the
management of depression occurs in primary care, approaches aimed at improving
the overall management of the condition have a major role to play in lessening
the burden of the disease.
PTSD
SSRIs
MAOIs
Melancholy
Rank theory
21st century
Antidepressants
Depression management strategies
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