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Alex Mitchell, Amol Vaze and Sanjay Rao of Leicester General Hospital in the U.K. estimate that about 1 in 5 people in developed nations will experience depression in their lifetime. That means that among a general patient population of 100, about 20 will develop the condition, but the typical doctor will find it in only 10 of those who have it. And among the 80 healthy people, the doctor will incorrectly identify depression...
This is significant because depression - especially if it goes untreated - can be debilitating for the patient and his or her family. Depression also carries an enormous societal burden, leading to missed work days, loss of productivity and increases in health-care spending for co-occurring conditions like sleep problems or anxiety. Further, those misdiagnosed with depression may end up being prescribed antidepressant medications that not only cost a lot but can have serious side effects, including lethargy and sexual dysfunction...
That's surely a worthy goal, although, at least in the U.S., it offers a classic example of the incentive problems in the current health-care system: if general practitioners spend extra time with each patient trying to diagnose psychiatric problems, they will see fewer patients in a day, which means fewer reimbursements overall from the insurance companies. So is there another...
Still, not all research has been conclusive. While it was baclofen's effect in a crack-addicted patient that first got Penn scientists interested (the patient, a paraplegic named Edward Coleman who was taking baclofen for muscle spasms, reported that it also cut his cravings for crack), a recently published multisite trial of the drug in cocaine addicts did not produce significant results. "We think one of the reasons is the dose," says Franklin, noting that most alcoholics who have reported the switch tend not to experience it at less than 80 mg per day; the cocaine trial used...
While traditional psychotherapists focus their treatments on the patient's interior - whether through pharmaceuticals like Prozac, mindfulness practices like meditation, or old-fashioned couch-bound therapy by the hour - practitioners of the burgeoning field of eco-therapy believe that patient care must include time spent in the great outdoors. "It's psychotherapy - as if nature really mattered," says Linda Buzzell-Saltzman, a psychologist and the founder of the International Association for Ecotherapy, which currently lists slightly more than 100 official members...