BMJ  2007;335:413-414 (1 September), doi:10.1136/bmj.39317.492130.BE

Letters

Is depression overdiagnosed?

Global perspectives

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

The debate on whether depression is overdiagnosed should take global and epidemiological perspectives into account.^{1 2}

Recent transnational epidemiological surveys have not confirmed that medicalisation of sadness is a general phenomenon in the community.³ Rather, a substantial proportion of individuals with depression, even of severe degree, do not receive drug or other professional treatments. This is especially so in developing countries (including Beijing and Shanghai in China), where typically less than 10% of people with mood disorders will ever receive any form of professional treatment.⁴

The epidemiological meaning of a "case" of depression (such as mild major depressive episode) may have little to do with whether the affected person needs psychiatric evaluation or drug treatment, or both. This is not unlike increasingly lenient public health definitions of physical conditions such as obesity or serum cholesterol concentrations in the general population. In the spirit of early intervention, psychosocial intervention or a change . . . [Full text of this article]

Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong Special Administrative Region

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