Many Antidepressant Users Have No History of Mental Disorders

A new study reveals that a majority of the people who use antidepressants in the United States never met the criteria for major depressive disorder (MDD).

Researchers at the Johns Hopkins Bloomberg School of Public Health (Baltimore, MD, USA) used data from the Baltimore (MD, USA) Epidemiologic Catchment Area (ECA) study between 1981 and 2005 to examine the prevalence of mental disorders, as assessed prospectively over multiple interviews with 1,071 individuals who reported current antidepressant use. Lifetime prevalence of common mood and anxiety disorders were evaluated based on four interviews, as well as other factors associated with current antidepressant use.

The results showed that 69% of the patients never met the criteria for MDD; 38% never met criteria for MDD, obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder throughout their lifetime. Female gender, Caucasian ethnicity, recent or current physical problems—such as loss of bladder control, hypertension, and back pain—and recent mental health facility visits were associated with antidepressant use, in addition to mental disorders. The study was published in the October 2015 issue of the Journal of Clinical Psychiatry.

“We all experience periods of stress, periods of sadness, and periods of self-doubt; these don’t make us mentally ill, they define us as human,” concluded lead author Yoichiro Takayanagi, MD, PhD, and colleagues. “Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.”

“With non-specialists playing a growing role in the pharmacological treatment of common mental disorders, practice patterns of these providers are becoming increasingly relevant for mental health policy,” said senior author Ramin Mojtabai, MD, PhD, MPH, commenting on an earlier study. “To the extent that antidepressants are being prescribed for uses not supported by clinical evidence, there may be a need to improve providers’ prescribing practices, revamp drug formularies, or undertake broad reforms of the health care system that will increase communication between primary care providers and mental health specialists.”

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