U.S. survey probes depression care

More than half of all people with major depression now seek treatment for the disorder, up from about one-third a decade ago. Even so, only 1 in 5 depressed people receives adequate antidepressant medication and psychotherapy, according to a national survey in the June 18 Journal of the American Medical Association.

The findings underscore the need for more-aggressive depression treatment and more referrals by primary-care physicians, who care for most people with major depression, concludes a team led by sociologist Ronald C. Kessler of Harvard Medical School in Boston.

In 2001 and 2002, the researchers interviewed a national sample of 9,090 adults, ages 18 and older. Major depression was diagnosed on the basis of the presence of symptoms such as extreme sadness, insomnia, and loss of interest in all activities.

About 16 percent of the sample, representing around 34 million people in the United States, had at some time suffered from major depression. In the year before being interviewed, 6.6 percent, representing 13.5 million people, suffered bouts of major depression. That roughly matches an earlier estimate of the prevalence of depression (SN: 2/16/02, p. 102: Available to subscribers at Disorder Decline: U.S. mental ills take controversial dip).

Major depression often interfered with daily functioning at home and at work, especially for the half of the depressed sample who exhibited severe symptoms.

Past research indicated that primary-care physicians often regard supportive counseling as better than medication in treating mild-to-moderate depression (SN: 3/11/95, p. 148). Physicians on the front lines need better studies of the effectiveness of specific antidepressants and psychotherapies, especially for severe depression, remarks physician Thomas L. Schwenk of the University of Michigan Medical Center in Ann Arbor.

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Bruce Bower has written about the behavioral sciences for Science News since 1984. He writes about psychology, anthropology, archaeology and mental health issues.

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