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  1  Depression-An under-recognized condition Non- attendance  (A) The Epidemiological Catchment Area Study carried out in the  USA  suggests that approximately one third of people suffering from depression do not seek help or treatment (B)A European survey   of 80,000 people also revealed third of people with major depression had not consulted a health-care specialist . Men were less likely to consult a medical specialist than women. Many believed --------They would get better by themselves Some--------------------Too embarrassed to seek help Other reasons why patients don’t consult doctors include : ã They may not recognise they have an illness ã They may regard their symptoms as appropriate in their circumstances ã Many people do not know depression can be treated easily ã Misconceptions over treatment Poor recognition   ã GPs manage about 80 per cent of all mental illness , but evidence suggests that depression is frequently missed in general practice. 1. Half of patients severe depression -----------not recognised at the first consultation. 2. A further 10%------------- Recognised in subsequent consultations. 3. 20%--------------------------Remit during this time. 4.The remaining 20%-------- may remain unrecognised even after six months 5.Recognising difficulty -----------presentations with somatic symptoms - 70% cases - and of depression related to physical disorders 1. O ther factors include an aversion on the part of both GPs and patients to talk about psychological problems and inadequate time for consultations    2   MAJOR DEPRESSIVE DISORDER OR  AFFECTIVE DISORDER( DEPRESSIVE EPISODE) INCIDENCE Male 5-12% Female 10-25% More in females, the ratio 2:1  Age 20-50 years  Average 40 years 3    Lifetime Prevalence of Various Mood Disorders Mood Disorder    Lifetime Prevalence Depressive disorders Major depressive disorder (MDD) 10  – 25% for women 5  – 12% for men   Recurrent, without full 25  – 30% of persons with MDD interepisode recovery, superimposed on dysthymic disorder (double depression) ã Dysthymic disorder   3  – 6% Bipolar disorders ã  Bipolar I disorder 0.4  – 1.6% ã Bipolar II disorder <1% ã Bipolar I disorder or bipolar II 5  – 15% of persons with disorder, with rapid cycling bipolar disorder Cyclothymic disorder    0.4  – 1.0% 4
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