20 May 2021

The Diamond cohort study – Better management of those at risk of persistent and disabling depression.

What began as a short, one-year study looking at how people who present with depressive symptoms were treated, the Diamond Study turned into a major 13-year project, following hundreds of patients through their primary care journey.

Australians take more antidepressants than almost anyone else in the world, and the number of prescriptions keeps rising, yet there is little evidence to guide for how long antidepressants should be used.

Lead Investigator, Professor Jane Gunn has had a keen interest in mental health since her days as a medical student and trainee doctor. It was very apparent to her that mental health care needs were prominent in all settings, but particularly in general practice where, in her words, 'addressing these needs is a key part of helping people get better'.

'During Diamond almost 800 people recruited from general practices across Victoria were followed for 10 years. 'This was the first time we had a solid understanding of how patients with depression presented to general practice and, more importantly, how they were being managed.

'After about 10 years we decided to start wrapping up the study because we kept finding the same things over and over. One big thing that really jumped out at us was the under-researched area of the connection between physical and mental health.

Professor Jane Gunn
Photo supplied by: The University of Melbourne​

Our study was one of the first to comprehensively demonstrate a link between the number of physical conditions a person has, and the increased likelihood they will experience depression.

'We also found that, along with physical illness, mental illnesses often coexist when there is childhood trauma, or financial stain.

'Despite the setbacks some individuals face, we saw time and time again in Diamond that human beings have a remarkable capacity to bounce back.'

'Professor Gunn and her team used the findings from Diamond to develop an innovative web-based tool to help GPs identify patients at risk of depressive symptoms and match them with tailored treatment options.

'Another recurring theme we found is that too often our approach to treating mental illness is lacking a tailored, holistic approach – and that much more attention needs to be paid to the way that health care is integrated in Australia.'

Next steps

Another issue that Professor Gunn is passionate about is the potential risk associated with long-term antidepressant use, a traditionally under-researched area, and the focus of her current research. 'I'd like to see that change, so my current research focus is looking to establish a body of research evidence, which I hope will lead t more evidenced-based, rational prescribing.'


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