ABSTRACT
Episodes of ‘major’ depression are twice as common in women as men. Major depression is strongly associated with adverse life and economic circum stances - such as unemployment, divorce or poor housing. Depression is the most common mental health problem in older people, especially those living in nursing and residential care. 10-15% of older adults aged over 65 years have significant depressive symptoms, although major depression is rare. Women are more likely to be depressed than men. Depressive symptoms are the fourth most important cause of disability worldwide. In the UK:
• about 90% of mental healthcare is delivered solely in primary care1 • depression accounts for 10% of all new diagnoses in primary care2 • antidepressant drugs account for 7% of UK primary care drug expenditure2 • untreated depressed patients use two to three times the annual medical
services compared to their non-depressed counterparts3 • depression is a stronger predictor of serious cardiac disease during the year
following cardiac catheterisation than smoking, severity of coronary artery disease and diminished left ventricular ejection fraction.4
