Depression in general practice

Depression is the most common, serious psychological disability presenting to general practitioners. Its prevalence varies from 0.6 to 36% of GP encounters depending on the method of diagnosis. Apart from methodological differences, some of this variability relates to barriers in the diagnostic process. These include 'doctor barriers' both personal and professional, 'consultation barriers', and real or perceived 'patient barriers'. Education and training of GPs to recognise and manage depression in all its guises is only one way of overcoming these barriers. Other ways include raising community awareness through public health campaigns and raising patient and doctor awareness by screening for depression in the course of seemingly unrelated consultations in 'at risk patients'. As 95% of depression is capable of being managed in general practice, GPs will need to be more active in this field to reduce the considerable burden of morbidity and mortality attributed to this condition.