Is depression over-diagnosed and over-treated?

Is depression over-diagnosed and over-treated?

(Medical Xpress)—A University of Liverpool study has found that people are increasingly diagnosed and treated with medication for depression when they are suffering 'normal' human experiences such as grief and sadness.

A report published in the British Medical Journal (BMJ) found that although the prevalence of depressive disorders is stable in the UK and US, rates of diagnosis have increased considerably. In England, anti-depressant prescriptions increased by 10 per cent a year between 1998 and 2010 and in the US, 11% of over 11s were prescribed anti-depressant drugs.

The report identifies a number of factors which are responsible for the increase including the lowering the threshold of what constitutes . The formal definition of depression was introduced by the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980 and resulted in and being diagnosed as depression.

In the most recent version of the manual, DSM-5 published last year, the definitions of depression have been broadened even further. It now puts a timescale of two weeks for a person to recover from a bereavement after which a can be diagnosed.

Professor Chris Dowrick, from the Institute of Psychology, Health and Society who also works as a GP, said: "Over diagnosis is now more common than under diagnosis. Evidence shows that anti-depressant medication has little or no effect on mild depression and the passing of time and other means of support generally make people feel better.

"In order to prevent unnecessary medication with its associated side-effects, risks and costs, the diagnostic criteria for defining depression need to be tightened up. Instead of prescribing medication, more attention needs to be given to support, advice, social networks and psychological interventions. GPs could then focus on those with serious mental health needs."

The report also argues that over-diagnosis and over-treatment are the result of heavy drug company marketing, a focus among many psychiatrists on the biology of psychiatric symptoms rather than their psychological, social, and cultural aspects, alongside increased requests from patients for medication and subsequent response from GPs.

More information: Dowrick C ,Frances A. "Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit." BMJ 2013;347:f7140. doi: dx.doi.org/10.1136/bmj.f7140

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baudrunner
not rated yet Jan 08, 2014
It is a sad fact that bi-polar disorder is probably the most over-treated medical condition that exists. I have lost two close friends over the last three years because of what I suspect was a drug-alcohol reaction. Both of them liked to drink, and both were being treated with seroquel for depression. They both died the same way, from internal hemorrhaging. One of them took no other medication except anti-histamines, while the other had a virtual pharmacy of medicines so numerous that he had difficulty keeping track of his regimen. But, they both died the same way. It's obvious to me that the risk of taking seroquel outweigh any benefit that the drug delivers, and yet it appears to be a liberally prescribed medication for what is often a superfluously diagnosed condition. I understand that pharmaceutical companies need to recoup their investment in bringing a new drug to market, which can be in the billions, but I disagree that this should be done at the cost of human life.
freethinking
1 / 5 (1) Jan 08, 2014
Just thinking out loud and would like to have a serious discussion about this (if you want to PM me about this please do so). What is wrong with depression? What is wrong with saying, if you feel depressed that is ok. What is wrong with saying, you have a right to be depressed and there is nothing wrong with it?

Could it be those that fear sadness are the problem? Are they so afraid of negative feeling that they need to drug themselves to feel good?

I've heard that some of the greatest leaders, artists, scientists were depressed most of the time. If they were drugged into happy-ness, they wouldn't have been great.