Expect One to Two Cases of Depression for Every Day of Office Practice
D'Arcy L Little, MD
Chief Resident, Department of Family Medicine,
Sunnybrook Campus of Sunnybrook and
Women's College Health Sciences Centre,
North York, Ontario
Depression is one of the most common illnesses seen by primary care doctors. The lifetime prevalence of this disease lies between 15 and 30%. It is estimated that one in 20 Canadians are suffering from depression at any given point in time, therefore the average family physician should expect to see one to two cases of significant depression for every day of office practice. Besides being common, depression causes significant morbidity in terms of suffering, disability, and cost to society, as well as a 15% mortality rate from suicide.
There is evidence that the recognition of depression and its early treatment improves outcome by decreasing suffering and improving function, quality of life and somatic symptoms. It is estimated, however, that between 35 and 50% of cases go undiagnosed. There can be numerous barriers to the diagnosis of this illness, for instance, only half of depressed people seek help specifically for this problem. However, the Ontario Health Survey [1990&endash;91] estimated that approximately 80% of depressed people did visit their family physician one or more times during the period of their illness for other reasons.