Warning depression is being ‘overdiagnosed’

Depression is being overdiagnosed because GPS are too reliant on a “basic” questionnaire funded by a pharmaceutical company that also makes psychiatric drugs, campaigners warn. The nine-point questionnaire was developed by academics funded by Pfizer and for most of the past 20 years a chart will have been present in virtually every GP’S consulting room. Critics say patients are being wrongly diagnosed as depressed as a result.

DEPRESSION is being overdiagnosed because GPS are too reliant on a “basic” questionnaire funded by a pharmaceutical company which also makes psychiatric drugs, campaigners warn.

The nine-question PHQ-9 Patient Health Questionnaire was developed by academics funded by Pfizer and, for most of the past 20 years, a chart will have been present in virtually every GP’S consulting room.

A similar tool used for detecting anxiety was also developed by Pfizerfunded research.

Critics say patients whose symptoms may be the result of unusually stressful or traumatic events in their lives are being labelled clinically depressed or anxious because GPS rely too heavily on the questionnaires.

A Us-based multinational company, Pfizer manufactures some of the most commonly prescribed drugs for depression and anxiety in the UK, such as Venlafaxine and Sertraline.

Dr James Davies, a researcher at the University of Roehampton and cofounder of the Council for Evidencebased Psychiatry, said: “GPS are very busy and they often don’t have time to do a full interview.

“These forms have a very low criteria for anxiety and depression.

“Millions of people have filled them in and got medication, but did they know they were developed by Pfizer?”

The PHQ-9 asks patients about the extent to which they have poor appetite, low energy, sleep and concentration levels, as well as feelings of low self-worth over the past fortnight. Each answer, such as “on several days” or “nearly every day”, is awarded a score.

The points are added up and matched against a scale, ranging from not depressed to severely depressed.

The GAD-7 Generalised Anxiety Disorder Assessment works in a similar way.

Previous studies have indicated that generalised criteria can be unreliable in accurately assessing patients’ mental health status, with trials showing that two psychiatrists will disagree on a diagnosis of major depressive or generalised anxiety disorders in up to 40 per cent of patients.

Brian Dow, from the campaign group Rethink Mental Illness, said: “There is no magic formula for diagnosing a mental illness – signs and symptoms in each person can be both varied and sometimes complex to decipher.”

However, Professor Sir Simon Wessely, president of the Royal College of Psychiatrists, said PHQ-9 and GAD-7 are “screening tools, not diagnostic criteria”. “They are used less and less by GPS and, where they are still used, scoring highly does not automatically lead to medication,” he said.

Dr Helen Stokes-lampard, chair of the Royal College of GPS, denied they applied a “one-sized-fits-all approach” to diagnosing mental ill-health.

The Government has promised 3,000 extra mental health therapists to work in GP practices by 2020.

A spokesman for Pfizer said that the questionnaires were designed to “support the evaluation and diagnosis of patients”.