Mental Health: depression and anxiety

Depression, sometimes referred to as unipolar depression, is a common mental disorder characterised by sadness, loss of interest in activities and by decreased energy. It is estimated that 5.8% of men and 9.5% of women will experience a depressive episode in any given year (WHO World Health report 2001: Mental health: new understanding; new hope').

Anxiety, like depression, is a universal human emotion. It is only when it is severe and persistent that it may be regarded as mental health problem. The main types of anxiety include phobias, panic attacks, obsessive compulsive disorder, post-traumatic stress disorder, as well the more severe forms of anxiety such as avoidant or anxious personality disorder personality.

In Scotland, Practice Team Information (PTI) data provides evidence of the high level of psychiatric morbidity seen in primary care:

• In 2003/2004, depression and anxiety were among the top ten conditions recorded at GP consultations

• Between April 2004 and March 2005, it is estimated that over half a million patients were seen by their GP for problems related to depression and anxiety (Table 1)

• Female patients were twice as likely to be seen by their GP for depression and anxiety, than male patients  (Table 1)

• Women and men aged 15-44 years were more likely to seen by their GP for depression and anxiety (Table 1)

Table 1. Depression and Anxiety - PTI annual prevalence rates per 1000 population for Scotland(1) years ending 31 March 2004 and 2005 (2) (3);  by sex and age group, standardised for deprivation

 

		2003-2004		2004-2005
Gender	Age group	Patients seen per 1,000 population	Estimated patients for Scotland (4)	Patients seen per 1,000 population	Estimated patients for Scotland (4)
Male	0-14	7.9	3,600	6.5	2,950
	15-44	92.3	107,800	91.3	106,750
	46-64	91.2	60,800	86.3	58,650
	65+	68.1	23,150	63.5	21,850
	All ages	74.2	195,350	71.8	190,150
Female	0-14	10.2	4,500	9.6	4,150
	15-44	201.6	225,600	195.8	219,200
	46-64	193.5	127,500	179.6	120,450
	65+	125.3	60,350	118.6	57,300
	All ages	155.0	417,950	148.2	401,100
Total		115.1	613,300	110.4	591,250

Source: ISD Practice Team Information.

Population source: Community Health Index (CHI) record, ISD Scotland, as at September 2003 and September 2004

 1. Prior to April 2003 data were collected only from GPs (Continuous Morbidity Recording (CMR)). From 1 April 2003 data collection was extended to encompass patient contacts with practice nurses, district nurses and health visitors (Practice Team Information (PTI))

2.Based on 45 and 44 practices which collected and submitted PTI data, years ending March 2004 and 2005 respectively.

3.Based on ISD's revised Standard Morbidity Groupings (SMG) for both ‘Depression & other affective disorders’ and 'Anxiety & other neurotic, stress-related, & somatoform disorders' .

4.Figures have been rounded to the nearest 50.  Totals do not equal the sum of the estimated numbers for each age group due to rounding.

notes:

(1) Prior to April 2003 data were collected only from GPs (Continuous Morbidity Recording (CMR)). From 1 April 2003 data collection was extended to encompass patient contacts with practice nurses, district nurses and health visitors (Practice Team Information (PTI)).

(2) Based on 45 practices which collected and submitted GP-only data, years ending March 2004 respectively.

(3) Figures have been rounded to the nearest 50. Totals do not equal the sum of the estimated numbers for each age group due to rounding.