Harold Pincus, M.D., Executive Vice Chair, Department of Psychiatry, University of Pittsburgh School of Medicine, and Senior Scientist, RAND Corporation and Director, RAND Pittsburgh Health Institute, University of Pittsburgh, Pittsburgh, Pennsylvania Depression, the second-leading cause of disease burden in the United States, is a chronic illness that affects 17 million people. The risk for depression ignores race, ethnicity, educational level, and socioeconomic status. Of critical concern is that the severity and impact of chronicity of this disease often gets overlooked.
Depression is extremely difficult to diagnose and manifests itself in a wide variety of ways.
The criteria for diagnosis of depression are often applied somewhat arbitrarily, and although depression is a common illness, it can easily be disguised, because those who suffer from it often function successfully in society. Irritability, loss of interest or pleasure in most activities, feelings of worthlessness or guilt. Research indicates that people diagnosed with depression have general medical costs twice those of healthy individuals and visit hospital emergency rooms with significantly greater frequency. Pharmaceutical costs are also overwhelming. Seven of the top 10 drugs covered by managed care programs in many States are medications for depressive disorders.