Prescribing patterns for depression and anxiety worldwide.

Psychiatric disorders, particularly depression and anxiety, present commonly in primary care worldwide. However, significant variation is seen between countries in the prevalence of these disorders. Differing levels of awareness and recognition due to cultural issues may be important contributing factors in this variation. Overall, roughly half of psychiatric cases presenting in primary care go unrecognized, and one third of cases recognized are misdiagnosed. Although treatment is offered in nearly 60% of recognized cases, it is seldom in the context of a specific diagnosis and is only appropriate in about 5% of cases overall. This article explores the transcultural variation in the recognition, diagnosis, and treatment of depression and anxiety disorders using data from the World Health Organization study on Psychological Problems in General Health Care. Patterns observed in Western societies are compared with those seen in the rest of the world and are discussed with a view to educational needs for primary care physicians.