Persistent Depressive and Anxiety Disorders Common in US
Dec 17, 2008
Research findings published in the December issue of Psychiatric Services suggest that persistent depression and anxiety disorders are common in the United States, but few of these patients receive appropriate treatment.
"Persistent psychiatric illnesses are a major national health care challenge," Dr. Alexander S. Young, of the University of California, Los Angeles, and colleagues write. "Relatively little is known about the national prevalence of persistent anxiety and depressive disorders in the United States or about treatment use in this population."
Dr. Young and his colleagues determined national estimates for the prevalence of persistent depression and anxiety, treatment use, treatment quality, and other factors in this population.
The team used data from a prospective, community-based cohort study of 1,642 adults with probable major depression, dysthymia, panic disorder or generalized anxiety. Telephone interviews were conducted between 1997 and 1998 and again an average of 32 months later to assess diagnosis, quality of life, treatment satisfaction, co-morbid conditions, suicidal ideation, and other variables.
The researchers estimated the overall national prevalence of persistent depression or anxiety disorder to be 4.7%. Within this subgroup, 87% subjects also had a chronic medical disorder. Another 51% had persistent suicidal ideation.
Only 12% of the patients were receiving appropriate drug therapy and counseling at follow-up, the researchers report. Appropriate drug treatment rose from 21% to 29%, but counseling rates declined from 23% to 19%. Men and subjects with less education were less likely to be receiving appropriate treatment.
"Improving the treatment of people with persistent depressive and anxiety disorders may require changes in policy and services, including support for care models that systematically increase treatment intensity when patients do not respond to initial treatment," Dr. Young and colleagues write.
"Improving care will require greater collaboration between primary care practitioners and mental health specialists and increased use of specialists," they add.
Psychiatr Serv 2008;59:1391-1398.
Dec 17, 2008
Research findings published in the December issue of Psychiatric Services suggest that persistent depression and anxiety disorders are common in the United States, but few of these patients receive appropriate treatment.
"Persistent psychiatric illnesses are a major national health care challenge," Dr. Alexander S. Young, of the University of California, Los Angeles, and colleagues write. "Relatively little is known about the national prevalence of persistent anxiety and depressive disorders in the United States or about treatment use in this population."
Dr. Young and his colleagues determined national estimates for the prevalence of persistent depression and anxiety, treatment use, treatment quality, and other factors in this population.
The team used data from a prospective, community-based cohort study of 1,642 adults with probable major depression, dysthymia, panic disorder or generalized anxiety. Telephone interviews were conducted between 1997 and 1998 and again an average of 32 months later to assess diagnosis, quality of life, treatment satisfaction, co-morbid conditions, suicidal ideation, and other variables.
The researchers estimated the overall national prevalence of persistent depression or anxiety disorder to be 4.7%. Within this subgroup, 87% subjects also had a chronic medical disorder. Another 51% had persistent suicidal ideation.
Only 12% of the patients were receiving appropriate drug therapy and counseling at follow-up, the researchers report. Appropriate drug treatment rose from 21% to 29%, but counseling rates declined from 23% to 19%. Men and subjects with less education were less likely to be receiving appropriate treatment.
"Improving the treatment of people with persistent depressive and anxiety disorders may require changes in policy and services, including support for care models that systematically increase treatment intensity when patients do not respond to initial treatment," Dr. Young and colleagues write.
"Improving care will require greater collaboration between primary care practitioners and mental health specialists and increased use of specialists," they add.
Psychiatr Serv 2008;59:1391-1398.
