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Millions of Americans extremely bummed, not getting treatment

Millions of Americans suffer from major depression each year, and most are not getting proper treatment for this debilitating disorder, according to a two-year nationwide study reported in the June 18 Journal of the American Medical Association. The study, led by researchers from Harvard Medical School, found high rates of major depressive episodes (MDE) in all segments of the U.S. population. The researchers measured the severity and duration of depression in more than 9,000 Americans 18 years or older and looked at MDE’s effect on daily activities and treatment received, if any.
From Harvard Medical School:Millions of Americans suffer from major depression

Only one fifth get adequate treatment, new study finds

BOSTON, MA?Millions of Americans suffer from major depression each year, and most are not getting proper treatment for this debilitating disorder, according to a two-year nationwide study reported in the June 18 Journal of the American Medical Association.

The study, led by researchers from Harvard Medical School, found high rates of major depressive episodes (MDE) in all segments of the U.S. population. The researchers measured the severity and duration of depression in more than 9,000 Americans 18 years or older and looked at MDE’s effect on daily activities and treatment received, if any.

“This is the first study to assess clinical severity of depression in a community sample,” said survey leader Ronald Kessler, HMS professor of health care policy.

“Critics have suggested that depression was over-estimated in earlier studies because of many people with mild depression being included even though they really don’t need treatment,” Kessler said. “But we built in a state-of-the-art clinical severity assessment, and we found that the majority of people with MDE are severe cases and only a small minority are mild cases. The average person with MDE in the past year reported an average of 35 days when they were unable to work or carry out other normal activities because of their depression.

“These findings confirm that depression is an enormous societal problem, both in terms of the number of people involved and in terms of clinical severity,” Kessler said.

Although most people reporting depression in the past 12 months received some kind of treatment ? an improvement over earlier findings ? only one in five received treatment that met minimum standards of treatment adequacy established by the Agency for Health Care Policy and Research.

The researchers found that this problem of inadequate treatment was due to a mix of inappropriate dosing of antidepressant medications on the part of physicians, patient discontinuation of treatment, and the use of unproven treatments outside the medical and mental health system.

“While recently increased treatment is encouraging, inadequate treatment is a serious concern,” Kessler and his co-authors write. “Emphasis on screening and expansion of treatment needs to be accompanied by a parallel emphasis on treatment quality improvement.”

The study found that women and people previously married were most at risk for major depression over a lifetime; in a 12-month period, MDE was more common among homemakers, people never married, and those who had not completed high school or who were living in poverty. Neither geographic region nor urban versus rural residence was closely related to MDE.

The researchers found MDE affects 13 to 14 million American adults?roughly 6.6 percent?in a given year. In a lifetime, 16.2 percent of Americans?about 33 to 35 million?suffer from MDE.



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