Underuse of Antidepressants in Major Depression: Prevalence and Correlates in a National Sample of Young Adults
J Clin Psychiatry 2000;61:234-237
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Epidemiologic studies have reported
disturbingly low rates of treatment for major depression in the
United States. To better understand this phenomenon, we studied
the prevalence and predictors of antidepressant treatment in a
national sample of individuals with major depression.
Method: Between 1988 and 1994, 7589 individuals,
aged 17-39 years and drawn from a national probability sample,
were administered the Diagnostic Interview Schedule as part of
the National Health and Nutrition Examination Survey.
Interviewers asked about prescription drug use and checked
medication bottles to record the name and type of medications.
Results: A total of 312 individuals, or 4.1% of
the sample, met DSM-III criteria for current major depression.
Only 7.4% of those with current major depression were being
treated with an antidepressant. Among individuals with current
major depression, being insured and having a primary care
provider each predicted a 4-fold increase in odds of
antidepressant treatment; telling the primary provider about
depressive symptoms predicted a 10 fold increase in treatment.
Conclusion: The study's findings support the
notion that a serious gap exists between the established efficacy
of antidepressant medications and rates of treatment for major
depression in the "real world." Underreporting of
depressive symptoms to providers and problems with access to
general medical care appear to be 2 major contributors to this