One In 13 Adults Experienced Depressive Episode In Past Year

An estimated 16.5 million people aged 18 years or older experienced at least one major depressive episode (MDE) in the past year and 64.5 percent of them received treatment, according to a new report released today by the Substance Abuse and Mental Health Services Administration (SAMHSA).
“Depression is a medical condition that should be treated with the same urgency as any other medical condition,” said SAMHSA Acting Administrator Eric Broderick, D.D.S., M.P.H. “This study helps us gain better insight into how many people suffer from major depressive episodes, where they seek treatment, and why they don’t. This information is critical to help inform health system reform.”
Among the findings:
* The rate of past year MDE was lower among persons aged 50 or older (5.8 percent) than among those aged 18 to 25 (8.9 percent) or 26 to 49 (8.5 percent). Overall the rate of past year MDE was 7.5 percent for adults aged 18 or older.
* The rate of MDE was higher for adults who perceived their overall health to be fair or poor (14.2 percent) than for those who described their health as excellent (4.3 percent).
* Among those with past year MDE who received treatment for depression in the past year, 68.8 percent saw or talked to a medical doctor or other health professional about depression and used prescription medication for depression.
* A quarter (24 percent) of those with MDE who received treatment for depression saw or talked to a medical doctor or other health professional but did not use a prescription medication.
According to the report one third of adults experiencing an MDE in the past year did not receive treatment during that period. The most frequently reported reasons for not receiving mental health services among these adults was not being able to afford the cost (43.2 percent), feeling they could handle the problem on their own (29.3 percent), not knowing where to go for services (18.1 percent), not having the time (16.7 percent), having health insurance that did not cover enough treatment (11.3 percent), and concerns about confidentiality (11.1 percent).
The report is drawn from SAMHSA’s 2007 National Survey on Drug Use and Health (NSDUH) which collected data from a representative sample of approximately 45,000 civilian, non-institutionalized adults throughout the United States.
MDE is defined as a period of two weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, including problems with sleep, eating, energy, concentration, and self-image.

Workplace Depression Screening, Enhanced Treatment Improves Productivity

Enhanced and systematic efforts to identify and treat depression in the workplace significantly improves employee health and productivity, likely leading to lower costs overall for the employer, according to a study published September 26, 2007, in the Journal of the American Medical Association. The study was funded by the National Institutes of Health’s National Institute of Mental Health (NIMH).
Previous studies have shown that employees who are depressed are less productive and are absent more often. Other studies have shown that organized screening and enhanced depression treatment can significantly improve health. However, few employers have implemented such programs, in part because their return on investment is unclear.
"This study provides compelling evidence of the importance of workplace depression screening, outreach, and enhanced treatment," said NIMH Director Thomas R. Insel, M.D. "It is in the interest of workers’ health and the company’s bottom line to ensure depressed employees are effectively treated."
Philip Wang, M.D., Dr.P.H., director of NIMH’s Division of Services and Intervention Research, and colleagues conducted a trial with 604 employees enrolled in a managed behavioral health care plan, all of whom were identified as having clinically significant depression during a Web-based and telephone screening process. Half of the participants were randomly assigned to an intervention that included telephone support from a care manager and their choice of telephone psychotherapy, in-person psychotherapy or antidepressant medication. The other half of the participants were assigned to usual care, which included feedback about their screening results, and advice to seek care from their usual provider.
After 12 months, those in the intervention group were 40 percent more likely to have recovered from their depression compared to those in usual care. Participants in the intervention group also were 70 percent more likely to stay employed, and worked an average of two more hours per week than those in usual care.
Although the data did not lend itself to a comprehensive cost/benefit analysis, the researchers noted that just the value of more hours worked among those in the intervention group who were employed, estimated at $1,800 per employee per year, far exceeds the $100-$400 per person costs associated with the type of outreach and intervention program used in the study.
"For many people, a large chunk of their lives is devoted to work. Depression affects not only a person’s health, but also his or her ability to work," noted Dr. Wang. "Employers should consider a depression screening and intervention program as a healthy, win-win investment."