Since 2000, there have been approximately 822 compounds for the treatment of depression that are currently in various stages of development (Table 1).
More than 70% of all of the depression compounds currently in clinical development are sponsored by a select number of organizations. The top organizations sponsoring such trials are listed in Table 2. Of these, approximately 28% of the compounds are sponsored by the National Institute of Mental Health in collaboration with other organizations.
Depression frequently presents in association with a chronic illness in the general population. The presence of comorbid depression has been shown to be predictive of worse outcomes of the medical illness and of increased mortality.1 Major depressive disorder affects approximately 14.8 million (6.7%) of the adult US population (18 or older) in any given year.2
Depression has been associated with the following medical conditions:
- 85% of patients with depression experience significant symptoms of anxiety3
- About 75% of patients with obsessive-compulsive disorder report that they have suffered from symptoms of depression4
- Chronic major depression increases the risk of cancer by 88% over 3.8 years of follow-up5
- Patients with cancer have a high rate of psychiatric comorbidity; approximately 50% of those with cancer have emotional difficulties6
- Nearly 50% of women diagnosed with early breast cancer had depression, anxiety, or both in the year after diagnosis7
- About 33% of patients with acute post–myocardial infarction are depressed; depression is a strong independent predictor of negative outcomes in patients with coronary artery disease8
- The prevalence for major depression among patients with HIV or AIDS has been estimated to be between 15% and 40%, far exceeding that seen in the general population9
- 40% of patients with Parkinson’s disease have comorbid depression.10 Not surprisingly, depression plays a major role in overall costs of healthcare services:
- Annual economic consequences of depression have been estimated at 11.5 billion euros in the United Kingdom and $83 billion in the United States
- The economic burden is staggering, with estimates running as much as $51.5 billion a year in lost productivity.11 An additional $26.1 billion is spent for medical treatment11
- More than 70% of people diagnosed with depression are employed, and depression results in 400 million lost work days annually, according to Keith Dixon, PhD, president of Cigna Behavioral Health. In the private sector, Dr Dixon notes, depressed employees use, on average, more than $4000/year in medical services compared with less than $1000/year used by employees without depression, making depression a significant component of healthcare costs12
- Employers pay almost 75% of the $80-billion price tag for treatment of depressive disorders each year.13
- Goodnick PJ, Hernandez M. Treatment of depression in comorbid medical illness. Expert Opin Pharmacother. 2000;1(17):1367-1384.
- Kessler RC, Chiu WT, Demier O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-627.
- Gorman JM. Comorbid depression and anxiety disorders. Depress Anxiety. 1996-1997;4:160-168.
- The University of Florida Obsessive-Compulsive Disorder Program. http://www.ufocd.org/OtherConditions.htm. Accessed February 20, 2006.
- Penninx BW, Guralnik JM, Pahor M, et al. Chronically depressed mood and cancer risk in older persons. J Natl Cancer Inst. 1998; 90(24):1888-1893.
- Derogatis LR, Morrow GR, Fetting J, et al. The prevalence of psychiatric disorders among cancer patients. JAMA. 1983;249(6):751-757.
- Burgess C, Corneliu V, Love S, et al. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005;330(7493):702.
- Vaccarino V, Karl SV, Abramson J, Krumholz HM. Depressive symptoms and risk of functional decline and death in patients with heart failure. J Am Coll Cardiol. 2001;38(1):199-205.
- Angelino AF, Treisman GJ. Management of psychiatric disorders in patients infected with human immunodeficiency virus. Clin Infect Dis. 2001;33(6):847-856.
- McDonald WM, Richard IH, DeLong MR. Prevalence, etiology, and treatment of depression in Parkinson’s disease. Biol Psychiatry. 2003; 54(3):363-375.
- Lerner D, Adler DA, Chang H, et al. Unemployment, job retention, and productivity loss among employees with depression. Psychiatr Serv. 2004;55(12):1371-1378.
- Dixon K. Direct costs of depression in the workplace are tip of the iceberg; employers have huge stake in promoting depression treatment. PRNewswire. October 13, 2005. http://www.prnewswire.com/cgibin/ stories.pl?acct=104&story=/www/story/10-13-2005/0004167764&e date. Accessed February 20, 2006.
- Durso KA. Depression in the workplace: prevalence, cost and productivity impact. Employee Benefit News. December 2004. http:// www.benefitnews.com/detail.cfm?id=6776&terms=%7Cpresenteeism% 7C. Accessed February 20, 2006.