Depression In The US Often Over-Diagnosed
May 1, 2013

Many People Treated For Depression In The US Don’t Actually Meet The Criteria

redOrbit Staff & Wire Reports - Your Universe Online

Depression is both over-diagnosed and over-treated in American adults, claims a new study published in the April 2013 edition of the journal Psychotherapy and Psychosomatics.

Dr. Ramin J. Mojtabai, lead author of the study and an associate professor at the Johns Hopkins Bloomberg School of Public Health´s Department of Mental Health, examined individuals with clinician-identified depression, as well as those who experienced a major depressive episode within a 12-month period.

Mojtabai and colleagues discovered that, after being assessed for major depressive episodes using structured interview, less than 39-percent of those who has been clinically diagnosed actually met the 12-month criteria for depression — despite the fact that the majority of study participants used and/or had received prescriptions for psychiatric medications such as anti-depressants.

“Depression over-diagnosis and over-treatment is common in the U.S. and frankly the numbers are staggering,” Mojtabai said in a statement. “Among study participants who were 65 years old or older with clinician-identified depression, 6 out of every 7 did not meet the 12-month major-depressive-episodes criteria.”

“While participants who did not meet the criteria used significantly fewer services and treatment contacts, the majority of both groups used prescription psychiatric medication,” the study author added.

The research team used a sample of more than 5,600 participants from the 2009-2010 US National Survey of Drug Use and Health (NSDUH). They asked questions about conditions that the subjects were informed they had by doctors or other medical personnel within the last 12 months to assess clinician-identified depression. Their study revealed that a majority of those interviewed said that they had taken prescription psychiatric medications, despite lacking a history of major or minor depression.

“A number of factors likely contribute to the high false-positive rate of depression diagnosis in community settings, including the relatively low prevalence of depression in these settings, clinicians' uncertainty about the diagnostic criteria and the ambiguity regarding sub-threshold syndromes,” Mojtabai said.

“Previous evidence has highlighted the under-diagnosis and under-treatment of major depression in community settings,” the professor added. “The new data suggest that the under-diagnosis and under-treatment of many who are in need of treatment occurs in conjunction with the over-diagnosis and over-treatment of others who do not need such treatment. There is a need for improved targeting of diagnosis and treatment of depression and other mental disorders in these settings.”