Over-diagnosis and over-treatment of depression is common in the US

April 30, 2013

Americans are over-diagnosed and over-treated for depression, according to a new study conducted at the Johns Hopkins Bloomberg School of Public Health. The study examines adults with clinician-identified depression and individuals who experienced major depressive episodes within a 12-month period. It found that when 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 majority of participants being prescribed and using psychiatric medications. The results are featured in the April 2013 issue of Psychotherapy and Psychosomatics.

"Depression over-diagnosis and over-treatment is common in the U.S. and frankly the numbers are staggering," said Ramin J. Mojtabai, PhD, author of the study and an associate professor with the Bloomberg School's Department of Mental Health. "Among who were 65 years old or older with clinician-identified depression, 6 out of every 7 did not meet the 12-month major- criteria. While participants who did not meet the criteria used significantly fewer services and treatment contacts, the majority of both groups used prescription ."

Using a sample of 5,639 participants from the 2009-2010 United States 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 and the ambiguity regarding sub-threshold syndromes," said Mojtabai. "Previous evidence has highlighted the under-diagnosis and under-treatment of major depression in community settings. 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."

Explore further: Prescriptions for antidepressants increasing among individuals with no psychiatric diagnosis

More information: "Clinician-Identified Depression in Community Settings: Concordance with Structured-Interview Diagnoses," was written by Ramin J. Mojtabai.

Related Stories

Prescriptions for antidepressants increasing among individuals with no psychiatric diagnosis

August 5, 2011
Americans are no strangers to antidepressants. During the last 20 years the use of antidepressants has grown significantly making them one of the most costly and the third most commonly prescribed class of medications in ...

How well is depression in women being diagnosed and treated?

August 20, 2012
Major depression affects as many as 16% of reproductive-aged women in the U.S. Yet pregnant women have a higher rate of undiagnosed depression than nonpregnant women, according to a study published in Journal of Women's Health.

Daily smoking, low mastery associated with repeat episodes of depression

October 24, 2011
Previous depression, daily smoking and a lack of control over life circumstances -- or "low mastery" -- are risk factors for repeat episodes of depression, states an article in CMAJ (Canadian Medical Association Journal).

One-third of adult Americans with arthritis battle anxiety or depression

April 30, 2012
Researchers from the Centers for Disease Control and Prevention (CDC) found that one-third of U.S. adults with arthritis, 45 years and older, report having anxiety or depression. According to findings that appear today in ...

Reports of mental health disability increase in US

September 23, 2011
The prevalence of self-reported mental health disabilities increased in the U.S. among non-elderly adults during the last decade, according to a study by Ramin Mojtabai, MD, PhD, of the Johns Hopkins Bloomberg School of Public ...

Recommended for you

Yoga and meditation improve mind-body health and stress resilience

August 22, 2017
Many people report positive health effects from practicing yoga and meditation, and experience both mental and physical benefits from these practices. However, we still have much to learn about how exactly these practices ...

Wealth disparity and family income impact the brain development of female youth

August 22, 2017
Female teenagers living in neighbourhoods with wide salary gaps and a low-income household show changes to their brain maturation that could indicate a higher risk of developing mental illness in adulthood, suggests a recently ...

High moral reasoning associated with increased activity in the human brain's reward system

August 22, 2017
Individuals who have a high level of moral reasoning show increased activity in the brain's frontostriatal reward system, both during periods of rest and while performing a sequential risk taking and decision making task ...

Brain's self-regulation in teens at risk for obesity

August 22, 2017
In a small study that scanned the brains of teenagers while exposing them to tempting "food cues," researchers report that reduced activity in the brain's "self-regulation" system may be an important early predictor of adult ...

New study rebuts the claim that antidepressants do not work

August 18, 2017
A theory that has gained considerable attention in international media, including Newsweek and the CBS broadcast 60 minutes, suggests that antidepressant drugs such as the SSRIs do not exert any actual antidepressant effect. ...

Should I stay or should I leave? Untangling what goes on when a relationship is being questioned

August 17, 2017
Knowing whether to stay in or leave a romantic relationship is often an agonizing experience and that ambivalence can have negative consequences for health and well-being.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.