‘Real-life burden of depression’ surveys – GP and patient perspectives on treatment and management of recurrent depression

Depression is a chronic, recurrent illness carrying a heavy burden for the health service and the community. Current evidence suggests that the majority of patients with depression will experience recurrent episodes of illness, although there is extensive evidence that continuation therapy with antidepressant drugs will prevent relapse. Two surveys were designed and distributed in the UK in 2002 to compare the expectations of patients and GPs in the management of relapse in depression. For the patient survey, 1010 completed questionnaires of the 7000 distributed (through the charity Depression Alliance), were returned for analysis and feedback. For the GP survey (endorsed by the charity Primary care Mental Health Education (PriMHE), 200 responses were received from the 400 GPs contacted. A majority of patients in the survey (85%) who experience depression expressed concern about recurrent episodes and 88% of respondents had suffered at least one repeat episode. The survey found that 65% of respondents had stopped taking their medication at some stage: reasons cited include unacceptable side-effects and lack of efficacy. The findings suggest that discontinuation and non-compliance of therapies is associated with recurrent depression. Continuation therapy is now standard treatment to avoid recurrent depression; however, the majority of GPs questioned, continued therapy for less than the 6 months after acute treatment response as advised by the British Associated of Psychopharmacologists. Although depression is generally managed well at primary care level, this survey highlights the major worries of depression sufferers concerning further episodes of depression and the need to prevent relapse and recurrence through safe and effective therapies with which these patients are happy to comply.