Mild depression in general practice: time for a rethink?

doi:10.1136/dtb.2003.41860

Drug and Therapeutics Bulletin 2003;41:60-64; doi:10.1136/dtb.2003.41860

Mild depression in general practice: time for a rethink?

Relevant BNF section: 4.3

Clinical studies, conducted chiefly in hospital settings, havedemonstrated that antidepressant drug therapy is effective treatmentfor major depressive disorder of at least moderate severity,¹and that cognitive therapy is an effective alternative to antidepressantsin mild to moderate major depression.² However, few clinicaltrials have taken place in general practice, where the greatmajority of patients with depression are managed. Most suchpatients in this setting do not meet diagnostic criteria formajor depression,^3,4 and are often described more loosely ashaving 'mild depression'. Many are given an antidepressant,often as the first step in treatment.⁵ Here, we consider whetherthis is the optimal approach for adults with mild depressionin general practice.