Improved targeting of
 depression treatment needed 
in community settings

May 28 2013

Relatively little is known about the prevalence and
 correlates of over diagnosis of depression in community settings.

This study
 examined the extent to which individuals with clinician-identified depression 
in the community meet the criteria for DSM-IV major depressive episodes (MDE)
and characteristics of these individuals.

 In a sample of 5,639 participants
with clinician-identified depression drawn from the 2009-2010 United States 
National Survey of Drug Use and Health, the proportion of participants who met 
the 12-month MDE criteria, ascertained by a structured interview, and 
variations in MDE diagnosis across different groups of participants were
 examined. Mental health profiles and service use of participants who met the
 MDE criteria were compared to those who did not meet these criteria. Only 38.4%
 of participants with 12-month clinician-identified depression met the 12-month 
MDE criteria.

Older adults were less likely than younger adults to meet the 
criteria - only 14.3% of those 65 years old or older met the criteria, whereas 
participants with more education and those with poorer overall health were more
 likely to meet the criteria. Participants who did not meet the 12-month MDE
 criteria reported less distress and impairment in role functioning and used
 fewer services.

A majority of both groups, however, were prescribed and used 
psychiatric medications. Depression overdiagnosis and over treatment is common 
in community settings in the USA. There is a need for improved targeting of
 diagnosis and treatments of depression and other mental disorders in these
 settings.

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