A new study from the Johns Hopkins Bloomberg School of Public Health suggests Americans are overdiagnosed and overtreated for depression.
Researchers examined adults with depression identified by a doctor or other medical professional, and individuals who experienced major depressive episodes within a 12-month period.
Investigators found that when these individuals were assessed for major depressive episodes using a structured interview, only 38.4 percent of adults with clinician-identified depression met the 12-month criteria for depression — despite the fact that a majority of participants were prescribed and were using psychiatric medications.
The results are featured in the journal Psychotherapy and Psychosomatics.
“Depression overdiagnosis and overtreatment is common in the U.S., and frankly the numbers are staggering,” said Ramin J. Mojtabai, Ph.D., author of the study and an associate professor with the Bloomberg School’s Department of Mental Health.
“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.”
From a sample of 5,639 participants from the 2009-2010 United States National Survey of Drug Use and Health, Mojtabai assessed clinician-identified depression based on questions about conditions that the participants were told they had by a doctor or other medical professional in the past 12 months.
The study indicates that even among participants without a lifetime history of major or minor depression, a majority reported having taken prescription psychiatric medications.
“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,” said Mojtabai.
Researchers lament that prior research suggested an underdiagnosis and undertreatment of major depression in community settings. Now, experts believe that both undertreatment and overtreatment of depression are occurring.
“The new data suggest that the underdiagnosis and undertreatment of many who are in need of treatment occurs in conjunction with the overdiagnosis and overtreatment of others who do not need such treatment,” Mojtabai said.