Letters Medicalising unhappiness

Underdiagnosis of depression in young people

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g170 (Published 21 January 2014) Cite this as: BMJ 2014;348:g170
  1. Paul David Sigalas, senior registrar in child and adolescent psychiatry1,
  2. Xanthe Barkla, senior registrar in child and adolescent psychiatry2,
  3. Paul McArdle, consultant in child and adolescent psychiatry2
  1. 1Northumberland Tyne and Wear Trust, Newcastle upon Tyne NE2 1QE, UK
  2. 2Benton House CYPS, Newcastle, UK
  1. paul.sigalas{at}ntw.nhs.uk

With regard to depressive illness, Dowrick and Frances state that “overdiagnosis is now more common than underdiagnosis.”1

From our own practice we find that this is unlikely. The yearly prevalence of depression is estimated at 0.9% in 5-16 year olds,2 and 5.6% in 13-18 year olds.3 In Newcastle there are currently 49 000 5-19 year olds,4 28 500 of whom are aged 5-14 years.5 A conservative extrapolation of the above data suggests that 944 young people in Newcastle have depression. The total number of young people currently within specialist mental health services in Newcastle for any mental health condition is 1387, so a substantial number of depressed young people are likely not to be receiving such services.

Indeed, national data suggest that only 27% of children and young people with mental disorders gain access to specialist mental health services.2 Furthermore, according to the same study, only 8% (5/64) of children with depression were prescribed antidepressant drugs. Among young people the evidence indicates gross under-recognition and underdiagnosis—this is the real crisis.


Cite this as: BMJ 2014;348:g170


  • Competing interests: None declared.


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