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= Paid-up subscribersPsychiatry: Raising standards of care for patients with depression
25 May 2011
Depression is common. Depression impairs occupational and social functioning, and has a significant impact on quality of life. Adults in the UK with a diagnosis of either ICD-10 depressive episode or ICD-10 mixed anxiety and depressive disorder have been estimated to have taken more than a quarter (9% and 20% respectively) of the total number of days of sickness absence in one year. Few patients receive effective treatment. There are four reasons for this: failure to seek help (40% don't attend); failure of GPs to recognise depression (30-50% of cases); non-adherence or early cessation of treatment (only about 25% of patients complete a six-month course of antidepressant treatment);lack of treatment efficacy (50% with moderate depression don't respond to initial treatment). Although there is a high rate of spontaneous recovery among those with mild depression, between one- and two-thirds of primary care patients with major depression have not fully recovered 12 months later. The main reason for this is that only about one in ten patients receive effective treatment.
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