The Course, Morbidity, and Costs of Depression

Eight independently conducted studies that were begun more than a decade ago when the morbidity of major depression, its clinical course, long-term treatment, and impact on children were unclear are reported in this issue of theArchives.1-9Using different sampling, different levels of severity of depression, different types and lengths of treatment, and patients of different ages, these studies provide an overview and replication of findings on course, morbidity, costs, and treatment of major depression. Cumulatively, the findings clearly show that depression is not ubiquitous, trivial, or transient. If the scope of outcome is broadened to include relapse, recurrence, comorbidity, chronicity, impact on family, absenteeism, and work productivity, it may not be humane, prudent, or economical to limit the identification of depression or shorten its course of treatment. This view may at first seem at variance with current efforts to reduce escalating health care costs or to manage cases.