Recent trends in the incidence of recorded depression in primary care.

Abstract

There is a paucity of data describing how general practitioners (GPs) label or record depression. To determine incidence and sociodemographic variation in GP-recorded depression diagnoses and depressive symptoms. Annual incidence rates calculated using data from 298 UK general practices between 1996 and 2006, adjusted for year of diagnosis, gender, age and deprivation. Incidence of diagnosed depression fell from 22.5 to 14.0 per 1000 person-years at risk (PYAR) from 1996 to 2006. The incidence of depressive symptoms rose threefold from 5.1 to 15.5 per 1000 PYAR. Combined incidence of diagnoses and symptoms remained stable. Diagnosed depression and symptoms were more common in women and in more deprived areas. Depression recorded by general practitioners has lower incidence rates than depression recorded in epidemiological studies, although there are similar associations with gender and deprivation. General practitioners increasingly use symptoms rather than diagnostic labels to categorize people's illnesses. Studies using standardised diagnostic instruments may not be easily comparable with clinical practice.