Major depression affects about five to ten per cent of the population of Western Europe. Most patients with depression consult a primary care physician with non-specific complaints. Under- recognition and under-treatment are common, despite the relatively high prevalence – about 10% – of major depression according to ICD-10 criteria in primary care. Results of several studies suggest that depression is not recognized in about 50% of people in primary care and under- recognition is accompanied by inadequate treatment. Depression is a major risk factor for suicide. There is evidence that almost half of primary care patients with current major depression will at some point develop suicidal ideation, often in periods between primary care visits. Primary care providers may be reluctant to inquire about suicidal thoughts out of a belief – unsupported by research findings – that such questions might exacerbate suicidal tendency.

The situation in the United States is rather similar to that in Europe.

Da: “What are the most effective diagnostic and therapeutic strategies for the management of depression in specialist care?” World Health Organization – Europe

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