Is depression overdiagnosed? Yes

doi:10.1136/bmj.39268.475799.AD

BMJ 2007;335:328 (18 August), doi:10.1136/bmj.39268.475799.AD

Feature

Head to head

Is depression overdiagnosed? Yes

Gordon Parker, scientia professor

School of Psychiatry, University of New South Wales, Randwick NSW 2031, Australia

g.parker@unsw.edu.au

Rates of diagnosis of depression have risen steeply in recentyears. Gordon Parker believes this is because current criteriaare medicalising sadness, but Ian Hickie argues that many peopleare still missing out on lifesaving treatment

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

It is normal to feel depressed. In our cohort study of 242 teachers,the 1978 baseline questionnaire defined depression as "a significantlowering of mood, with or without feelings of guilt, hopelessnessand helplessness, or a drop in one's self-esteem or self-regard."¹Ninety five per cent of the cohort reported such feelings (witha mean of six episodes a year), indicating the ubiquitous natureof depressed mood states.

A low threshold for diagnosing clinical depression, however,risks normal human emotional states being treated as illness,challenging the model's credibility and risking inappropriatemanagement. When the first antidepressant (imipramine) was developed,manufacturer Geigy was reluctant to market it,² judging therewere insufficient people with depression. Now, depression isall around, and antidepressant drugs have a dominant share ofthe drug market. Reasons for the overdiagnosis include lackof a reliable and valid diagnostic model and marketing of treatmentsbeyond their true . . . [Full text of this article]

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