Depression in the US: Are the Right Patients Getting Treatment?
A new study in JAMA Internal Medicine found that most Americans with depression do not receive treatment whereas most who do receive treatment do not screen positive for depression.
Although a recent rise in the use of antidepressants has been seen, there are still concerns that many adults with depression do not receive treatment and that some receive treatment that do not match the severity of their illness. Researchers from Columbia University Medical Center (CUMC) and the University of Pennsylvania set out to characterize the treatment of adults with depression in the United States. The team analyzed data on screen-positive depression, psychological distress, and depression treatment data from 46,417 responses to the Medical Expenditure Panel Surveys taken in U.S. households by individuals aged ≥18 years in 2012–2013.
Main outcome measures included percentages of adults with screen-positive depression and adjusted odds ratios (AORs) of the effects of sociodemographic characteristics on odds of screen-positive depression. In addition, percentages with treatment for screen-positive depression and AORs, percentages with any treatment of depression and AORs, and percentages with depression treatment by healthcare professionals (eg, psychiatrists, other healthcare professionals, general medical providers), and type of depression treatment all stratified by distress levels were also evaluated.
Researchers found that about 8.4% of adults screened positive for depression with only 28.7% having received any depression treatment. Among all adults treated for depression, however, only 29.9% had screen-positive depression and 21.8% had serious psychological stress. Adults with serious psychological distress who received treatment for depression were more likely to receive care from psychiatrists (33.4% vs. 17.3%; P<0.001) or other mental health specialists (16.2% vs. 9.6%; P<0.001), compared to those with less serious psychological distress. These individuals were also less likely to receive depression care solely from general medical providers (59.0% vs. 74.4%; P<0.001) and were more likely to receive psychotherapy (32.5% vs. 20.6%; P<0.001), but not antidepressants (81.1% vs. 88.6%; P<0.001).
Study authors highlighted the importance in working to "align depression care with each patient's clinical needs."
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