Is depression overdiagnosed? No

doi:10.1136/bmj.39268.497350.AD

BMJ 2007;335:329 (18 August), doi:10.1136/bmj.39268.497350.AD

Feature

Head to head

Is depression overdiagnosed? No

Ian Hickie, executive director

Brain and Mind Research Institute, University of Sydney, Camperdown NSW 2050, Sydney, Australia

ianh@med.usyd.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 appropriate for the wider community to ask if the benefitof the huge increase in the treatment of depression over thepast 15 years has outweighed any harm. If increased treatmenthas led to demonstrable benefits, and is cost effective, thendepression is not yet being overdiagnosed. From a health andeconomic perspective, we can give a clear answer—moreadults are alive and well, and we can easily afford to treatmore. Increased treatment of depression reduces suicides¹ ²and increases productivity.³ The provision of appropriate medicaland psychological care is also cost effective.⁴

The increased rate of diagnosis has had other benefits, includingreduced stigma, removal of structural impediments to employmentand health benefits, increased access to life insurance, improvedphysical health outcomes, reduced secondary alcohol and drugmisuse, and wider public understanding of the risks and benefitsof coming forward for care.⁵ We have at last abandoned . . . [Full text of this article]

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