Elderly, Men, Minorities Not Getting Treated for
70% who were depressed had received no treatment;
those who were male, Mexican- or African-American or over 80 least
likely to receive treatment
By Milly Dawson, HBNS
Feb. 6, 2014 - A leading cause of disability,
depression rates are increasing in the U.S. and under-treatment is
widespread, especially among certain groups including men, the poor, the
elderly and ethnic minorities, finds a new study in General Hospital
The study provides “useful data for health care
professionals and policy makers” as it may lead to better identification
of depressed patients needing care, said lead author Saranrat
Wittayanukor, a doctoral student in the department of health outcomes
research and policy at Auburn University’s Harrison School of Pharmacy.
The researchers used data from 13,320 U.S. adults
over 18. These adults answered a nine-question survey widely used to
diagnose depression. In the sample, 24.1 percent were depressed, with
36.6 of the depressed group having moderate-to-severe depression.
Overall, 70 percent of depressed people in the study had received no
The study highlighted specific demographic factors
associated with having depression, including being obese, poor, female,
having certain chronic illnesses, such as arthritis and asthma, and
lacking health insurance.
It also brought to light demographic factors that
influenced the chances that a depressed patient would receive treatment.
Among people with moderate to severe depression, for whom current
guidelines recommend the use of antidepressants, those who were female,
white and young were most likely to receive treatment. Having certain
other illness, such as arthritis or hypertension, and having had a prior
hospitalization also increased the odds of treatment.
Participants who were male, Mexican- or
African-American, and older than 80 were identified as being at special
risk for receiving no treatment.
“This elegant, nationally representative study
highlights the remarkably low rate of any depression treatment for those
in the most need,” said Bradley Gaynes, M.D., MPH, professor of
psychiatry at the University of North Carolina School of Medicine.
For the most severely depressed patients, only half
received any treatment and only 1 in 7 had received any antidepressants
in the prior year. “This severely depressed group is the one for whom
the benefits of treatment, especially medication, are most clearly
established,” noted Gaynes.
The study also showed, added Gaynes, that for
patients with moderate or moderate-to-severe depression, only 1 in 5
received any treatment and only 1 in 4 received medication.
Greater societal awareness of the widespread
problem of untreated depression and of the special vulnerability of
certain groups is much needed, said Gaynes. It’s important information,
he said, “for patients, who may avoid discussing depression due to
stigma, for clinicians who may not discuss depression because doing so
cuts into the time they have to address other conditions, and for
payers, who may question the need to cover its care.”
Source: Health Behavior News Service, part
of the Center for Advancing Health - www.cfah.org
General Hospital Psychiatry is a
peer-reviewed research journal published bimonthly by Elsevier Inc.
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