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Only one in three patients with depression initiate treatment
Approximately one-third of patients newly diagnosed with depression start antidepressant medication or psychotherapy, according to research published in Journal of General Internal Medicine.
“Depression is prevalent and costly, but despite effective treatments, is often untreated,” Beth Waitzfelder, PhD, from Kaiser Permanente Center for Health Research, and colleagues wrote.
Waitzfelder and colleagues conducted a retrospective observational study to identify patient characteristics that affect initiation of treatment for depression and treatment choice. The researchers analyzed electronic health record data of 241,251 adults who received a new diagnosis of depression in a primary care setting between 2010 and 2013.
New depression episodes were detected using ICD-9 codes for depression after a year with no depression diagnosis or treatment. Completing a psychotherapy session or filling a prescription for antidepressant medication within 90 days of diagnosis were considered initiation of treatment. The researchers used scores from the Patient Health Questionnaire (PHQ-9) to measure depression severity.
Data revealed that treatment was initiated in 35.7% of patients with newly diagnosed depression. Patients with more severe depression (PHQ-9 score of 10) were more likely to initiate treatment, with 53% starting medication or psychotherapy. Eighty percent of patients who began treatment chose antidepressant medication over psychotherapy.
Compared with patients aged 44 years and younger, those aged 60 years and older were half as likely to start treatment. Elderly patients aged 75 years or older were less likely to initiate psychotherapy than younger patients aged between 18 and 29 years (7% vs. 25%).
There was a 30% lower likelihood of treatment initiation among Asians, non-Hispanic blacks and Hispanics than non-Hispanic whites. Minority patients began psychotherapy significantly more often than medication.
“Our study, which was much larger than previous studies, provides important new evidence about the current scope of the problem among leading health care systems across the country that are striving to improve depression care in primary care settings,” Waitzfelder said in a press release. “Screening for depression in primary care is a positive step toward improving detection, treatment and outcome for depression, but disparities persist. We need a better understanding of the patient and other factors that influence treatment initiation.” – by Alaina Tedesco
Disclosure: Waitzfelder reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.