Task of primary care is to grade depression

doi:10.1136/bmj.39317.481134.BE

BMJ 2007;335:413 (1 September), doi:10.1136/bmj.39317.481134.BE

Letters

Is depression overdiagnosed?

Task of primary care is to grade depression

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

Sadness is normal because life can be difficult.¹ ² Sadnessin bereavement, for example, is appropriate and healthy—Ihope my children will be sad after I've gone. However, sadnessis not depression: when it is combined with cognitive, emotional,somative, and behavioural features it becomes the syndrome ofdepression, with its multifactorial aetiology, so common inprimary care. But diagnosis does not mean that treatment ormedicalisation is needed. The Diagnostic and Statistical Manualof Mental Disorders (III and IV) divides major depressive disorderinto mild, moderate, and severe. The mild form is usually selflimiting and responds to cognitive behavioural therapy, support,counselling, St John's wort, reading helpful books, etc. Itdoes not really require a doctor so much as supportive, informedlistening people, which risks undermining the serious messagewhen doctors are useful.