NEW YORK, Jan 08 (Reuters Health) – Among people receiving treatment for depression in the US, the percentage of those on antidepressant medication has risen dramatically, while fewer are opting for time on the couch in psychotherapy, according to a new report.
And more people are being treated for depression than ever before, the study finds, suggesting that the stigma associated with depression may be declining.
Lead author Dr. Mark Olfson of Columbia University in New York and colleagues compared trends in outpatient treatment for depression in 1987 and 1997.
In 1987, roughly 7 of every 1,000 people received outpatient treatment for depression, according to the report in the January 9th issue of The Journal of the American Medical Association. That number rose to 23 per 1,000 in 1997.
Thirty-seven percent of people being treated for depression in 1987 took antidepressant drugs, compared with nearly 75% in 1997. About 71% of people being treated for depression in 1987 received psychotherapy, while by 1997 that percentage had fallen to about 60%.
And the percentage of people who received their depression treatment from doctors increased from about 70% in 1987 to nearly 90% in 1997, the report indicates.
The researchers also found that more insurers were paying for depression treatment; 55% of these costs were covered by third-party payers in 1997, versus 39% in 1987.
“These changes suggest that access to mental health services has increased and that there has been an increased emphasis on (drug) treatments,” Olfson and colleagues write.
The introduction of the antidepressant Prozac, or fluoxetine, in 1987 was a major factor behind these trends, the authors note. Prozac and other drugs known as selective serotonin reuptake inhibitors have fewer side effects than the previous class of antidepressant drugs, known as tricyclics. The newer medications have a less complicated dosing regimen, and are also much less dangerous when taken in overdose.
The last decade also saw a huge increase in the advertising of these newer medications, the researchers point out, as well as a considerable amount of media coverage of depression.
“As a result of these developments, the public may have become more accepting of pharmacologic treatment of depression,” Olfson and colleagues write.
In the study, the researchers evaluated data from a survey of more than 32,000 Americans on depression treatment and medication use.
In the US, experts estimate that during any given year, between 5% and 10% of the population experiences major depression, according to the report.
SOURCE: The Journal of the American Medical Association 2002;287:203-209