Depression Affects More Than 1 in 20 Americans: CDC

Susan Jeffrey

September 05, 2008

September 5, 2008 — A new report from the Centers for Disease Control and Prevention's (CDC's) National Center for Health Statistics shows that in any 2-week period, 5.4%,of Americans aged 12 years or older, or more than 1 in 20, are depressed.

Hardest hit are women, non-Hispanic blacks, and those in middle age, between 40 and 59 years of age, where rates were higher than among other demographic groups. Americans living below the poverty level were more likely to be depressed than those with higher incomes; rates in this population were 1 in 7.

"Approximately 80% of people with depression reported that their symptoms interfered with their ability to work, maintain a home, and be socially active," the authors, Laura A. Pratt, PhD, and Debra J. Brody, both from the National Center of Health Statistics, write in their report. "Reflecting the high rate of functional impairment, almost two-thirds of the estimated $83 billion that depression cost the United States in the year 2000 resulted from lowered productivity and workplace absenteeism."

In addition, they note, 35% of males and 22% of females with depression reported that their symptoms made this kind of functioning very or extremely difficult, and even among those with mild depressive symptoms, more than half reported some difficulty in functioning attributable to their symptoms.

 

The new report is based on data taken from the National Health and Nutrition Survey 2005 – 2006, the latest installment of the ongoing national cross-section survey of the noninstitutionalized US population aimed at assessing the health and nutrition of Americans. The current numbers, then, do not include institutionalized populations, where rates of depression are even higher, the authors note.

Despite being a treatable condition, only 29% of those with depression reported contact with a mental health professional within the past year, and only 39% of those with severe depression reported such contact, the authors write.

"There are many reasons people with depression do not receive treatment," they write. "Some do not realize they have an illness that can be treated. Others do not believe that treatment works." Other barriers include the stigma that surrounds mental illness and mental health treatment, they note, as well as lack of insurance coverage for mental health care.

Overreporting of Problem?

Asked for comment on the findings of the new report, Jack Drescher, MD, from New York Medical College, and a member of the committee for public affairs at the American Psychiatric Association, said that in a cross-sectional study such as this one, a finding that 5.4% of the population is depressed at any given time is higher than he would have expected. "If 5% of Americans are depressed 'in the moment,' so to speak, that would mean a much larger lifetime prevalence of depression, which I think would be a new kind of number," he told Medscape Psychiatry.

Dr. Drescher suggested the methodology of this study, involving a questionnaire and a follow-up interview only, may not have been the best method to describe a condition such as depression. "Sometimes you have to dig a little deeper in psychiatric diagnostic interviews — for example, to help the person distinguish between what is and is not a symptom."

That people are not seeking treatment from mental health professionals is consistent with previous information, he said. "We already know that the majority of people receiving treatment for a psychiatric problem or receiving psychotropic medications are getting them from primary-care doctors," he noted. The general underutilization of mental health services in general has also been previously shown, "so that people who need treatment might not be getting it is not surprising."

 

On the other hand, if this is an overreporting of the numbers, it may be that many people do not think of what they are experiencing as a mental health problem and may not necessarily seek treatment, he added.

However, he concluded, "If this study is correct, and if further studies are able to support these findings, then it becomes a method to communicate to the general public that this is not such an unusual problem and that people might want to think more about getting help for it. Studies that show these conditions are more common than people believe tend to help in destigmatizing these conditions."

National Center for Health Statistics Databrief: Depression in the United States Household Population 2005 – 2006. September 2008.

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