Depressed Patients Receive Inadequate Treatment

By Maryellen Grady | January 2, 2010 | 92 views

Many adults with major depression living in the U.S. do not receive treatment or therapy based on treatment guidelines. In addition, some racial and ethnic groups have even lower rates of adequate depression care, says a report in the January 2010 issue of Archives of General Psychiatry, one of the journals of the American Medical Association.

Depression is a leading cause of disability among many racial and ethnic groups in the United States, according to information provided in the study. Drug therapy including the use of antidepressants is often the first treatment choice in most facilities where depression is treated. This leads to unpleasant and unwanted side effects, frequently does not alleviate the depression, and sometimes exacerbates it. Psychotherapy, another popular form of treatment for depression, can be effective and well-tolerated, but it does little to bring relief to the depressed in the short term.

Previous research suggests many depressed individuals are untreated or undertreated, but most studies of depression care have not distinguished between the two treatment modalities, and have also grouped major racial and ethnic groups. For instance, they combine all Latino individuals instead of looking at specific subgroups, such as Mexican Americans and Puerto Ricans.

Hector M. Gonz�lez, Ph.D., of Wayne State University, Detroit, along with his colleagues, assessed the prevalence and adequacy of depression care among different racial and ethnic groups in the United States by analyzing data from the National Institute of Mental Health�s Collaborative Psychiatric Epidemiology Surveys. This initiative combines three nationally representative studies, during which face-to-face interviews were conducted with 15,762 individuals age 18 and older throughout the country between 2001 and 2003.

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Of the adults surveyed, 8.3 percent had major depression, including 8 percent of Mexican Americans, 11.8 percent of Puerto Ricans, 7.9 percent of Caribbean blacks, 6.7 percent of African Americans and 8.5 percent of non-Latino whites.

Overall, more than half of those with depression received at least one form of depression care, but only about one in five (21.3 percent) had received at least one form of therapy that conformed to established treatment guidelines within the previous year. Psychotherapy was more commonly used than drug therapy, and individuals undergoing psychotherapy were more likely to receive treatment in alignment with clinical guidelines than were individuals taking drugs.

Mexican American and African American individuals with depression consistently had lower odds of receiving any type of care, or care in concordance with treatment guidelines during the year prior. �The proportions of Puerto Rican and non-Latino white individuals who used concordant therapies in the past year were nearly twice those of Mexican American, Caribbean black and African American individuals,� the authors write.

These findings point to the need for breaking down large ethnic and racial groups into smaller sub-categories, the authors note. "Failing to do so obscures depression care research, especially for the largest and fastest-growing segment of the U.S. population, Latino individuals, and especially Mexican American individuals."

�With the recent passing of a U.S. Mental Health Parity Act, our findings should provide guidance to better-enable mental health to improve the depression care of all Americans and for reducing disparities among ethnic/racial minorities,� they conclude.

Editor's note: This study describes a dismal situation, incidence of depression on the increase and effective treatment on the decrease. It underscores the need forprevention of depression. Recent research continues to point to the omega 3 fats found in a diet that features fish or in fish oil capsules as nature's way to prevent depression.

A scientist at Massachusetts General Hospital recently reported that patients with major depressive disorder have a high rate of cardiovascular disease occurrence at the same time, signaling a deficiency of omega 3 fatty acids. They reported data from placebo-controlled treatment studies that suggests omega-3 fatty acids are a reasonable strategy for the treatment of major depressive disorders. (Omega-3 fatty acids in major depressive disorder. Freeman MP. J Clin Paychiatry. 2009;70 Suppl 5:7-11.)

In a review of data at the David Geffen School of Medicine at UCLA, treatment for late-life mood disorders and cognitive aging was assessed. The areas showing the most beneficial effects agaist mood disorders and cognitive aging were found to be exercise, the use of fish oil, herbal therapy with Hypericum perforatum, and to a lesser extent, acupuncture and relaxation therapies. (Complementary and alternative medicine use for treatment and prevention of late-life mood and cognitive disorders. Lavretsky H. Aging health. 2009 Feb 1;5(1):61-78.)

Preventing and treating depression with omega 3 fats is inexpensive and involves no side effects. Results are quick and sustainable with continuous usage. This can be accomplished by taking Omega 3 Plus (120) capsules on a daily basis.

About The Author:

Maryellen Grady is a freelance writer who frequently writes about alternative health.