Is depression under-recognised and undertreated?

Most patients with a psychiatric disorder consult their general practitioner (GP) within one year. The majority of these patients are depressed or belong to the depressive spectrum. As other epidemiological studies, the World Health Organization (WHO) study conducted on 25916 primary care patients found a high prevalence of depressive episodes according to ICD10 (10.4%) and of dysthymics (2.1%). Among those, only 54% were recognised as having psychological problems by their GP. A specific diagnosis of depression was done in only 15%. When patients were identified as cases, 24 % were prescribed antidepressants while, when they were identified as depressed, antidepressant prescription was 43%. Factors influencing recognition were: reason for contact, sex, severity, disability, age, the existence of a physical disease. Interestingly, reasons for prescription (independently from recognition) were very similar.