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GP consultations for depression have risen since financial crisis hit

Rates of depression have risen since the financial crash of 2008, particularly among working-age men, according to an analysis of general practice records.

The increase, which was linked to rising male unemployment, was mainly seen in the poorest areas of the country – and marks a reversal of falling rates of depression seen in the years preceding the economic downturn.

Researchers led by Professor Tony Kendrick, professor of primary care in medicine at the University of Southampton, studied GP records of depression before and after the recession, using anonymised data from 142 practices contributing to the Clinical Practice Research Datalink between 2003 and 2013.

The overall rate of depression – recorded through either diagnostic or symptom codes – fell by 15% between 2003 and 2008, but then rose again, by 4%, up to the end of March 2013.

Looking more closely, the researchers found the increase after the recession was only statistically significant in men, not in women – and that this increase correlated with a rise in unemployment since 2008, according to Office of National Statistics data.

Furthermore, the increase in depression was only seen in the most socioeconomically deprived areas. Rates of depression flatlined after 2008 in all but the lowest quintile of deprivation, in which they rose significantly.

Professor Kendrick told Pulse the increase in depression rates explained some – but not all – of the rise in antidepressant use recorded by the Health Survey for England. That data showed GP prescriptions of antidepressants had rocketed – by around 50% – since 2008, with one in 10 people now prescribed them overall, rising to nearly one in five among women from the poorest groups.

Professor Kendrick said: ‘[Our study] helps to explain the rise in prescribing – but it doesn’t account for all of it. That may be because each patient is getting more prescriptions. One of the things we want to now do is look at the length of treatment – we think they are getting longer courses.’

Professor Kendrick added that his group will also look at how changes in the way GPs record depression may reflect different treatment patterns – the study found GPs are increasingly moving towards symptom rather than diagnostic codes for depression, such that less than half of patients with symptoms were on the QOF register of depression.

J Affect Disord 2015; 180: 68-78


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