GP leaders agreed there could be a case for expanding the framework's depression screening indicator.

The researchers compared 2004/5 disease prevalence data from 8,576 practices in England with national Prescribing Analysis and Cost data on antidepressant prescribing.

A high COPD prevalence was the single strongest predictor of a high antidepressant prescribing rate.

Epilepsy, CHD and asthma prevalence were also strongly linked to antidepressant prescribing.

Other predictors included social deprivation and ethnicity.

Lead researcher Dr Paul Walters, from the Institute of Psychiatry in London said: 'Although we couldn't measure actual rates of depression in these illnesses, this study provides evidence that depression screening should be considered in patients with COPD and asthma.' Dr Tim Saunders, GP and mental health lead for Chester West PCT backed screening for depression in all patients with chronic diseases.

'These patients could be screened for depression when they come in for their patient review, as those with diabetes and CHD currently are,' he said.

GPC deputy chairman Dr Richard Vautrey agreed that quality framework (QOF) points for depression screening in patients with CHD and diabetes could be extended to cover COPD and asthma.

'When this indicator is reviewed, if there is evidence that depression is linked to COPD and other respiratory diseases then they could be included,' he said.

GPletters@haymarket.com

• B J Psych 2008; 193: 235-9

Indicators

• High COPD prevalence was the strongest predictor of a high antidepressant prescribing rate.
• Epilepsy, CHD and asthma prevalence were also linked.
• Under the QOF, practices screen diabetes and CHD patients for depression.

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