Treatment of Adult Depression in the United States

Olfson, Mark; Blanco, Carlos; Marcus, Steven C.

doi:10.1001/jamainternmed.2016.5057

Cited by 283 publications

(226 citation statements)

References 46 publications

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“…targeted questions prompted by signs or patient concerns). Since prior research 5,15 has demonstrated that clinical case finding misses as many as half of the patients with depression, this raises the concern that a significant portion of adults, especially those without obvious depressive symptoms, are not having their mental health needs assessed.…”

Section: Key Findingsmentioning

confidence: 99%

Missed Opportunities for Depression Screening and Treatment in the United States

et al. 2018

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Purpose: This study estimates the prevalence of depression assessment in adults age 35 and older and how prevalence varies by sociodemographic characteristics and depressive symptoms.Methods: We used a nationally representative survey, the Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey, to evaluate if adults 35؉ were being assessed for depression by their health care providers in 2014 and 2015. Using multivariate logistic regression, we examined the health and sociodemographic characteristics of patients associated with depression assessment.Results: Approximately 50% of US adults aged 35؉ were being assessed for depression (48.6%; 95% CI, 45.5%-51.6%). The following were less likely to be assessed

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Section: Key Findingsmentioning

confidence: 99%

Missed Opportunities for Depression Screening and Treatment in the United States

et al. 2018

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“…Although effective treatment approaches exist [6,7], depression is still undertreated: a recent study suggests that only 28.7% of individuals screening positive for depression in the USA receive treatment [8], supporting similar findings from cross-national studies [9]. Major reasons for the insufficient treatment of mental disorders in general, and of depression in particular, are limitations in transportation and logistics (e.g., long-distance drives, not being able to take time off work), financial barriers (i.e., not being able to afford treatment), and fear of stigmatization within affected individuals [10].…”

Section: Introductionmentioning

confidence: 99%

Benefits of Individualized Feedback in Internet-Based Interventions for Depression: A Randomized Controlled Trial

Zagorscak

Heinrich

Sommer

et al. 2018

Psychother Psychosom

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Background: Even though there is an increasing number of studies on the efficacy of Internet-based interventions (IBI) for depression, experimental trials on the benefits of added guidance by clinicians are scarce and inconsistent. This study compared the efficacy of semistandardized feedback provided by psychologists with fully standardized feedback in IBI. Methods: Participants with mild-to-moderate depression (n = 1,089, 66% female) from the client pool of a health insurance company participated in a cognitive-behavioral IBI targeting depression over 6 weeks. Individuals were randomized to weekly semistandardized e-mail feedback from psychologists (individual counseling; IC) or to automated, standardized feedback where a psychologist could be contacted on demand (CoD). The contents and tasks were identical across conditions. The primary outcome was depression; secondary outcomes included anxiety, rumination, and well-being. Outcomes were assessed before and after the intervention and 3, 6, and 12 months later. Changes in outcomes were evaluated using latent change score modeling. Results: Both interventions yielded large pre-post effects on depression (Beck Depression Inventory-II: d_IC = 1.53, d_CoD = 1.37; Patient Health Questionnaire-9: d_IC = 1.20, d_CoD = 1.04), as well as significant improvements of all other outcome measures. The effects remained significant after 3, 6, and 12 months. The groups differed with regard to attrition (IC: 17.3%, CoD: 25.8%, p = 0.001). Between-group effects were statistically nonsignificant across outcomes and measurement occasions. Conclusion: Adding semistandardized guidance in IBI for depression did not prove to be more effective than fully standardized feedback on primary and secondary outcomes, but it had positive effects on attrition.

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“…data, however, suggested that among patients screened for MDD, only 27.8% received treatment during follow-up. 13 These alarming numbers suggest that efforts beyond screening are needed to remediate the lack of initial and ongoing treatment. Studies on barriers to care help identify limitations of the screening programs and explain, in part, the large rates of untreated NPPDs and SUDs.…”

Section: The Association Of Untreated Illness With Morbidity and Mortmentioning

confidence: 99%

Duration and Relevance of Untreated Psychiatric Disorders, 2: Nonpsychotic Psychiatric Disorders and Substance Use Disorders

Rubio¹,

Correll²

2017

J. Clin. Psychiatry

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Treatment of Adult Depression in the United States

Cited by 283 publications

References 46 publications

Missed Opportunities for Depression Screening and Treatment in the United States

Missed Opportunities for Depression Screening and Treatment in the United States

Benefits of Individualized Feedback in Internet-Based Interventions for Depression: A Randomized Controlled Trial

Duration and Relevance of Untreated Psychiatric Disorders, 2: Nonpsychotic Psychiatric Disorders and Substance Use Disorders

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