The economic and social burden of depression.

Depressive disorders are a major public health problem. They occur frequently and produce severe suffering for those affected and for their families. They are ubiquitous and appear at all ages. The consequences of depressive disorders in terms of excessive mortality, disability, and secondary morbidity are grave. There are indications that the frequency of depressive disorders will increase in the years to come, for a variety of reasons, including demographic changes, extended life expectancy of people suffering from chronic physical disorders, and iatrogenic causes. The essential criterion for designating a condition as a major public health problem--that there should be an effective intervention that will diminish or eliminate the problem-has now also been met. Recent years have seen the development of a variety of new treatments that can be applied even in situations where highly specialized mental health staff are scarce. These developments make training in the use of new treatment methods of proven value and their wide application a public health priority and an ethical obligation. The presentation will discuss these issues on the basis of accumulated evidence and experience.