Diagnosing and Treating Depression in a Managed Care Environment: Concerns, Perceptions, and Misperceptions

Depression remains underdiagnosed, and even when it is diagnosed it is undertreated. Exploratory discussions with providers from managed care environments have yielded several perspectives that might help to explain the well-documented poor performance in the treatment of depression. This supplement, derived from the proceedings of the Economic Working Group's third advisory board, examines perceptions and misperceptions in the managed care marketplace and examines them in light of the published literature.


  • If so many patients currently are prescribed antidepressants, why is the disease still undertreated?
  • If so many people suffer from depression, why are physicians not diagnosing it?
  • Did patients who were noncompliant with antidepressant medications need the medications in the first place?
  • Aren't depression disease management programs extremely expensive?
  • Don't national guidelines stipulate discontinuation of antidepressant therapy at or before 6 months?
  • Does HEDIS play a big role in improving the care of patients with depression?