title: Prevalence, risk factors, and use of health care in depression: a survey in a large region of France between 1991 and 2005.
abstract: OBJECTIVE
  To compare the prevalence, risk factors, and use of care for depression between 2 periods, concerning changes in social factors and health care provision.
  
  
  METHODS
  We compared data from 2 surveys carried out in a large urbanized French region (Ile-de-France) 15 years apart (1991, n = 1192; 2005, n = 5308), using comparable methodology and tools.
  
  
  RESULTS
  The overall prevalence of depression has slightly increased over this period. In contrast, the tendency of people who claim they feel depressed has dramatically increased. At-risk populations have also changed during this period. The proportion of people consulting a psychiatrist for depression has not changed, while general practitioner (GP) consultations have decreased and psychologist consultations have increased 3-fold. Psychotropic use by people who are depressed has decreased significantly.
  
  
  CONCLUSIONS
  The trend toward increased depressive symptoms does not correspond to an increase in depressed disorders. In a well-staffed urbanized French region, psychologists are playing a growing role in managing depression at the expense of GPs, when the use of a psychiatrist remains unchanged; decreased use of psychotropic drugs may be a consequence.
authors.affiliation: Université Paris Descartes (Equipe d'Accueil 4096), Fondation Mutuelle Générale de l'Education Nationale pour la Santé Publique, Paris, France. fsp@mgen.fr
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
authors.forename: Xavier
authors.initials: X
authors.lastname: Briffault
authors.forename: David
authors.initials: D
authors.lastname: Sapinho
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011570:Psychiatry / Q000706:statistics & numerical data; D011586:Psychology, Clinical / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs