[Research report 'the appropriate prescribing of antidepressants in general practice': who is better served by more diagnoses and more antidepressants?]

Abstract

Recently a report entitled 'The appropriate prescribing of antidepressants in general practice' was published. The researchers conclude that depression and anxiety are still more under-diagnosed than over-diagnosed and that antidepressants are frequently prescribed even when they are not indicated. Why this is so remains unclear. Looking for better interventions to improve treatment and increase therapy compliance, this study reports that many types of intervention could help but it is not very specific on how this could be achieved. Improving communication and knowledge about prescribing and how and when to discontinue treatment, are among the suggestions made in the report. Many questions remain: (a) is under-diagnosis a problem in a condition that often resolves spontaneously with watchful waiting?, (b) why are antidepressants so widely prescribed when their effectiveness is controversial and they have major adverse reactions?, (c) why are other treatment options such as talking therapy and a short period psychological intervention, of which the effectiveness has been established, not more frequently applied?