What Purpose Are These Guidelines Designed For?
Each year, every GP will see between 60 and 100 people with depression. However, it has been
reported that only about 30% - 50% of depression in primary care is recognised. It can extend to
affect wider family members - the emotional cognitive development of socially deprived children of a depressed mother is especially affected, with boys more vulnerable than girls.
• each year 1 in 15 women and 1 in 30 men are affected by depression.
• most of the 4,000 suicides committed in England each year are attributed to depression.
• depression can be a major risk factor both for development of cardiovascular disease,
 and death after a myocardial infarction.
• depression can also be associated with chronic illness such as arthritis.
• depression rates in people from African-Caribbean, Asian, refugee and asylum seeker
communities can be as much as 60% higher than in the white population.
Reported shortfalls in depression management include such things as prescribing anti-depressant medication in incorrect doses, over-prescription of such medication and also discontinuation
problems, use of poorly evidenced therapy e.g. counselling over more efficacious ones e.g. CBT,
and failure to provide sufferers with adequate information about their treatment. These guidelines are designed to assist GPs and other key professionals to assess and manage Depressed patients in
the Primary Care setting, and to ensure timely and appropriate referrals to specialist services when required.
How Were Service Users Consulted?
• Engagement of Salford Mental Health Forum (User group) in development and endorsement of
the guidelines (see intro section).
What Aspects Will Be Monitored & Measured To Assess Impact In Primary Care?
• prescribing practices for anti-depressant medication
• retrospective analysis of referrals to specialist services
What Evidence And/Or National Guidance Was Used In Developing The Guidelines?
- Paykel, E & Priest, R, Recognition, and management of depression in General Practice:
consensus statement. British Medical Journal 305, 1198-1202 (1992).
- NHS Centre for Reviews and Dissemination. The treatment of Depression in Primary Care.
Effective Health Care Bulletin 5 (1993).
- H.M. Government. National Service Framework for Mental Health: Modern Standards &
Service Models (HMSO, London, 1999).
- Clinical Standards Advisory Group, Depression in Primary Care (DoH, London, 1999).
- Bazire, S (2000) Psychcotropic Drug Directory. Quay Books, Wilts U.K.
- B A P Guidelines (2000).
- British National Formulary.
Who Designed These Guidelines?
Core members of mental health guidelines development group. (See introduction section).
Flowchart 1
Flowchart 2
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