Research informing antidepressant prescription and the validity of tools for the assessment of depression
Against a rising background of concern about the increasing volume of chemical antidepressant prescriptions, it became Scottish Health Department policy to reduce antidepressant prescription in Scotland by 10% in 2007. Research conducted at the University of Aberdeen into the treatment of depressive disorder analysed levels of prescription and also the rating instruments used to assess depression. This research demonstrated that GPs were already very conservative in their prescription of antidepressants and, in fact, tended to under-prescribe. The Aberdeen researchers also indicated that changes relating to the dose and duration of antidepressant prescription accounted for the rise in prescription volumes (rather than relating to the number of people being treated).
In light of the Aberdeen research, the recommended rating instruments were shown to be imprecise for measuring the severity of depression by medical professionals. As a result of the Aberdeen research and other international evidence, NICE (the National Institute for Health and Care Excellence) “retired” those measures that the Aberdeen researchers had described as invalid.
Key Publications
- Cameron, IM, Lawton, K & Reid, IC. (2009). Appropriateness of antidepressant prescribing: an observational study in a Scottish primary-care setting.British Journal of General Practice, 59, 566, 644-649.
- Cameron, IM, Crawford, JR, Lawton, K & Reid, IC. (2008). Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. British Journal of General Practice, v 58, 546, 32-36.
- Cameron, IM, Cardy, AH, Crawford, JR, du Toit, S, Hay, S., Lawton, K, Mitchell, K, Sharma, S, Shivaprasad, S, Winning, S & Reid, IC. (2011). Measuring depression severity in general practice: discriminatory performance of the PHQ-9, HADS-D, and BDI-II. British Journal of General Practice, 61, 588, e419-e426.