BMJ  2005;330:800-801 (9 April), doi:10.1136/bmj.330.7495.800

Editorial

Managing depression in primary care

Public confidence needs to be restored after concerns over the safety of SSRIs

The first 150 words of the full text of this article appear below.

Depression is a condition of "particular concern, which costs lives and affects the quality of life," according to UK prime minister Tony Blair.¹ Nine out of 10 depressed patients are treated only in primary care,^{2 3} and up to two thirds of suicide victims contact a general practitioner in the four weeks before the death.⁴ For years, however, general practitioners have been criticised for failing to deal adequately with depression. Like hypertension, depression is subject to a rule of halves—only half of depressed patients seek help from doctors, half are detected in primary care, half receive treatment with only half completing it: fewer than 10% finish a therapeutic course of treatment.⁵ A range of initiatives, often erroneously based on educational models for general practitioners, has aimed to improve detection rates and to increase the appropriateness of prescribing in depression with variable success, including a spectacular failure, in Hampshire, to influence . . . [Full text of this article]

Health Services Research Department, Institute of Psychiatry, London SE5 8AF

Department of General Practice and Primary Care, GKT School of Medicine, London SE11 6SP (roger.jones@kcl.ac.uk)

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Rapid Responses:

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The precise diagnosis of depression in primary care can also decrease over concern about treatment

Antonio E Nardi
bmj.com, 11 Apr 2005 [Full text]

overstating the case

Christopher F Dowrick
bmj.com, 12 Apr 2005 [Full text]

Integrating complementary medicine into the management of depression.

Charlotte Paterson
bmj.com, 14 Apr 2005 [Full text]

try honesty

Roelof A. Bijkerk
bmj.com, 14 Apr 2005 [Full text]

A pseudoepidemic of depression

Derek A Summerfield
bmj.com, 14 Apr 2005 [Full text]

Nothing "pseudo" about my depression

Dr Christopher L. Manning
bmj.com, 18 Apr 2005 [Full text]

Early & Effective Intervention in Depression

Mamdouh EL-Adl, et al.
bmj.com, 4 May 2005 [Full text]

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