Journal Mobile Options
Table of Contents
Vol. 77, No. 2, 2008
Issue release date: January 2008

Increase in Antidepressant Medication in the US Adult Population between 1990 and 2003

Mojtabai R.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Background: The rate of antidepressant treatment in the US has significantly increased in the past decade. There are, however, concerns about undertreatment among traditionally underserved groups and overtreatment in less severely ill individuals. This study examines trends in the prevalence of antidepressant drug treatment in two US general population surveys. Methods: The prevalence of antidepressant treatment within a 12-month period was compared in the US National Comorbidity Survey (1990–1992) and the National Comorbidity Survey-Replication (2001–2003). Variations in trends across groups were examined using bivariate and multivariate logistic regression models. Results: The rate of antidepressant drug treatment increased more than four times between early 1990s and early 2000s. The trend was similar across sociodemographic groups. Younger adults, men and racial/ethnic minorities continued to receive antidepressant treatment at a lower rate compared to middle-aged adults, women and non-Hispanic whites, respectively. The rate of antidepressant treatment increased more in the group of less severely ill individuals than in those with more severe psychopathology. Conclusions: Sociodemographic disparities in antidepressant treatment persisted over the last decade in the US, lending support to concerns about undertreatment among traditionally underserved groups, whereas the greater increase in the rate of antidepressant treatment in the less severely ill group lends support to concerns about antidepressant overtreatment in this population.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Beck CA, Patten SB, Williams JV, Wang JL, Currie SR, Maxwell CJ, El-Guebaly N: Antidepressant utilization in Canada. Soc Psychiatry Psychiatr Epidemiol 2005;40:799–807.
  2. Brugha TS, Bebbington PE, Singleton N, Melzer D, Jenkins R, Lewis G, Farrell M, Bhugra D, Lee A, Meltzer H: Trends in service use and treatment for mental disorders in adults throughout Great Britain. Br J Psychiatry 2004;185:378–384.
  3. Hall WD, Mant A, Mitchell PB, Rendle VA, Hickie IB, McManus P: Association between antidepressant prescribing and suicide in Australia, 1991–2000: trend analysis. BMJ 2003;326:1008.
  4. Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pincus HA: National trends in the outpatient treatment of depression. JAMA 2002;287:203–209.
  5. Greenfield SF, Reizes JM, Muenz LR, Kopans B, Kozloff RC, Jacobs DG: Treatment for depression following the 1996 National Depression Screening Day. Am J Psychiatry 2000;157:1867–1869.
  6. Regier DA, Hirschfeld RM, Goodwin FK, Burke JD Jr, Lazar JB, Judd LL: The NIMH Depression Awareness, Recognition, and Treatment Program: structure, aims, and scientific basis. Am J Psychiatry 1988;145:1351–1357.
  7. Elliott C, Chambers T: Prozac as a Way of Life. Chapel Hill, University of North Carolina Press, 2004.
  8. Kramer PD: Listening to Prozac. New York, Penguin Books, 1997.
  9. Fava GA: The intellectual crisis of psychiatric research. Psychother Psychosom 2006;75:202–208.
  10. Fava GA: Long-term treatment with antidepressant drugs: the spectacular achievements of propaganda. Psychother Psychosom 2002;71:127–132.
  11. Kravitz RL, Epstein RM, Feldman MD, Franz CE, Azari R, Wilkes MS, Hinton L, Franks P: Influence of patients’ requests for direct-to-consumer advertised antidepressants: a randomized controlled trial. JAMA 2005;293:1995–2002.
  12. Croghan TW: The controversy of increased spending for antidepressants. Health Aff (Millwood) 2001;20:129–135.
  13. Druss BG: Rising mental health costs: what are we getting for our money? Health Aff (Millwood) 2006;25:614–622.
  14. Oxman TE, Sengupta A: Treatment of minor depression. Am J Geriatr Psychiatry 2002;10:256–264.
  15. Hermens ML, van Hout HP, Terluin B, van der Windt DA, Beekman AT, van Dyck R, de Haan M: The prognosis of minor depression in the general population: a systematic review. Gen Hosp Psychiatry 2004;26:453–462.
  16. Blazer DG, Hybels CF, Simonsick EM, Hanlon JT: Marked differences in antidepressant use by race in an elderly community sample: 1986–1996. Am J Psychiatry 2000;157:1089–1094.
  17. Melfi CA, Croghan TW, Hanna MP, Robinson RL: Racial variation in antidepressant treatment in a Medicaid population. J Clin Psychiatry 2000;61:16–21.
  18. Sherbourne CD, Weiss R, Duan N, Bird CE, Wells KB: Do the effects of quality improvement for depression care differ for men and women? Results of a group-level randomized controlled trial. Med Care 2004;42:1186–1193.
  19. Frank RG, Glied S: Better but not Well: Mental Health Policy in the United States since 1950. Baltimore, Johns Hopkins University Press, 2006.
  20. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS: Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:8–19.
  21. Kessler RC, Merikangas KR: The National Comorbidity Survey Replication (NCS-R): background and aims. Int J Methods Psychiatr Res 2004;13:60–68.
  22. Wittchen HU: Reliability and validity studies of the WHO Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 1994;28:57–84.
  23. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3, revised (DSM-III-R). Washington, American Psychiatric Association, 1987.
  24. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4 (DSM-IV). Washington, American Psychiatric Association, 1994.
  25. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593–602.
  26. Kessler RC, Berglund P, Borges G, Nock M, Wang PS: Trends in suicide ideation, plans, gestures, and attempts in the United States, 1990–1992 to 2001–2003. JAMA 2005;293:2487–2495.
  27. Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L: The Hopkins Symptom Checklist (HSCL). A measure of primary symptom dimensions. Mod Probl Pharmacopsychiatry 1974;7:79–110.
  28. Mojtabai R: Residual symptoms and impairment in major depression in the community. Am J Psychiatry 2001;158:1645–1651.
  29. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002;32:959–976.
  30. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003;60:184–189.
  31. Kessler RC, Frank RG: The impact of psychiatric disorders on work loss days. Psychol Med 1997;27:861–873.
  32. Kessler RC, Demler O, Frank RG, Olfson M, Pincus HA, Walters EE, Wang P, Wells KB, Zaslavsky AM: Prevalence and treatment of mental disorders, 1990 to 2003. N Engl J Med 2005;352:2515–2523.
  33. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS: The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003;289:3095–3105.
  34. Newsom JT, Prigerson HG, Schulz R, Reynolds CF, 3rd: Investigating moderator hypotheses in aging research: statistical, methodological, and conceptual difficulties with comparing separate regressions. Int J Aging Hum Dev 2003;57:119–150.
  35. Hosmer DW, Lemeshow S: Applied Logistic Regression. New York, Wiley, 2000.
  36. Stata Statistical Software, release 9.2. College Station, Stata Corporation, 2006.
  37. Andrews G, Henderson S: Unmet Need in Psychiatry: Problems, Resources, Responses. Cambridge, Cambridge University Press, 2000.
  38. Wang PS, Demler O, Olfson M, Pincus HA, Wells KB, Kessler RC: Changing profiles of service sectors used for mental health care in the United States. Am J Psychiatry 2006;163:1187–1198.
  39. Berardi D, Menchetti M, Cevenini N, Scaini S, Versari M, De Ronchi D: Increased recognition of depression in primary care. Comparison between primary-care physician and ICD-10 diagnosis of depression. Psychother Psychosom 2005;74:225–230.
  40. Mojtabai R: Datapoints: prescription patterns for mood and anxiety disorders in a community sample. Psychiatr Serv 1999;50:1557.
  41. Fava GA: Do antidepressant and antianxiety drugs increase chronicity in affective disorders? Psychother Psychosom 1994;61:125–131.
  42. Perlis RH, Beasley CM Jr, Wines JD Jr, Tamura RN, Cusin C, Shear D, Amsterdam J, Quitkin F, Strong RE, Rosenbaum JF, Fava M: Treatment-associated suicidal ideation and adverse effects in an open, multicenter trial of fluoxetine for major depressive episodes. Psychother Psychosom 2007;76:40–46.
  43. Office of the Surgeon General: Mental Health: A Report of the Surgeon General. Rockville, Department of Health and Human Services, 1999.
  44. Anderson IM: Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 2000;58:19–36.
  45. Barbui C, Hotopf M: Amitriptyline v. the rest: still the leading antidepressant after 40 years of randomised controlled trials. Br J Psychiatry 2001;178:129–144.
  46. Faravelli C, Cosci F, Ciampelli M, Scarpato MA, Spiti R, Ricca V: A self-controlled, naturalistic study of selective serotonin reuptake inhibitors versus tricyclic antidepressants. Psychother Psychosom 2003;72:95–101.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50