Prevalence, Risk Factors, and Use of Health Care in Depression: A Survey in a Large Region of France between 1991 and 2005

In a well-staffed urbanized French region, psychologists are playing a growing role in managing depression at the expense of GPs, when the use of a psychiatrist remains unchanged; decreased use of psychotropic drugs may be a consequence.

Abstract

OBJECTIVE: To compare the prevalence, risk factors, and use of care for depression between 2 periods, concerning changes in social factors and health care provision. METHOD: We compared data from 2 surveys carried out in a large urbanized French region (Ile-de-France) 15 years apart (1991, n = 1192; 2005, n = 5308), using comparable methodology and tools. RESULTS: The overall prevalence of depression has slightly increased over this period. In contrast, the tendency of people who claim they feel depressed has dramatically increased. At-risk populations have also changed during this period. The proportion of people consulting a psychiatrist for depression has not changed, while general practitioner (GP) consultations have decreased and psychologist consultations have increased 3-fold. Psychotropic use by people who are depressed has decreased significantly. CONCLUSION: The trend toward increased depressive symptoms does not correspond to an increase in depressed disorders. In a well-staffed urbanized French region, psychologists are playing a growing role in managing depression at the expense of GPs, when the use of a psychiatrist remains unchanged; decreased use of psychotropic drugs may be a consequence.