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Unlike psychotics who thrust themselves into the priority list, benign depressives rarely get precedence in management. The alacrity and ease with which other medical professionals refer psychotics and other restless patients to psychiatrists is not seen when they deal with depressives. Depression is a high–prevalence disorder with moderate–to–severe intensity and accounts for one–third of cases visiting primary healthcare clinics. In the community, depression remits and recurs, and the frequency of remission may lead clinicians to underestimate the probability of relapse.

Depression is a chronic, relapsing, recurrent disorder, the fourth most important determinant of the global burden of disease, and the largest determinant of disability in the world. As patients do not seek treatment and when they do, efficacious treatments are not always used effectively, there is little hope of reducing this burden.

Comparing depression with other illnesses with high burden, such as coronary heart disease (CAD), cancer and AIDS, shows interesting patterns. The high–profile AIDS has a low lifetime prevalence of 0.2, compared to depression with a prevalence of 15 and the other two with a lifetime prevalence of around 6–7. A majority of people suffering from depression (more women) and AIDS (more men) are in their 20s to 40s, while CAD and cancer patients (equal men and women) are usually beyond the age of 45. CAD and cancer have a high recognition rate, variable treatability and survival rates, while AIDS has a high recognition rate, low treatability and low survival rate. In contrast, depression has a poor recognition rate, but excellent treatability and excellent survival rate with adequate treatment. In addition, the cost per year of treating depression is very low as compared to the other illnesses.

Read more: Cough up for Just a Cup of Coffee: Pharmacoeconomics of Depression