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Detection and treatment of depression in neurological disorders
  1. Niruj Agrawal1,
  2. Hugh Rickards2
  1. 1Department of Neuropsychiatry, St George's Hospital, London, UK
  2. 2Department of Neuropsychiatry, Edgbaston, Birmingham, UK
  1. Correspondence to Niruj Agrawal, Department of Neuropsychiatry, Clare House, St George's Hospital, Blackshaw Road, London SW17 0QT, UK; niruj.agrawal{at}swlstg-tr.nhs.uk

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Depression is common and under-recognised in neurological disorders. The evidence is that it can be treated and that this improves outcomes.

There is a steady accumulation of evidence from studies in community, primary care, neurological and neurorehabilitative settings that depression is a common comorbidity with a wide range of central nervous system conditions. Yet, the rate of recognition and treatment of depression in neurological settings remains worryingly low.1 While the reasons for low rates of detection and treatment of depression could be numerous, one of the factors which may contribute towards low rates of treatment could be a lack of evidence to support the treatment of depression in neurological patients. In Price et al2 (see page 914), a robust meta-analysis of RCTs shows that treatment with antidepressants in patients with neurological disorders is associated with twice the chance of remission 6–8 weeks after the onset of treatment.

The importance of early detection and treatment of depression in neurological settings is supported by growing evidence. The effect of depression on quality of life of patients with neurological conditions is now well recognised.3 4 Depression is also shown to affect the duration of hospital stay, engagement in treatment and outcome of treatment including residual disability and mortality. …

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