RT Journal
A1 Marcus SC, Olfson M
T1 NAtional trends in the treatment for depression from 1998 to 2007
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2010
FD December 6
VO 67
IS 12
SP 1265
OP 1273
DO 10.1001/archgenpsychiatry.2010.151
UL http://dx.doi.org/10.1001/archgenpsychiatry.2010.151
AB Context 
    The rate of outpatient treatment of depression increased markedly in the United States between 1987 and 1997; it is not known whether this trend has continued.Objective 
    To assess national trends in the outpatient treatment of depression between 1998 and 2007.Design and Setting 
    Analysis of service utilization data from 2 nationally representative surveys of the US household population, the 1998 (n = 22 953) and 2007 (n = 29 370) Medical Expenditure Panel Surveys.Participants 
    Nationally representative sample of the US household population.Main Outcome Measures 
    The rate of depression treatment and, among patients who received treatment, the rate of antidepressant medication use, psychotherapy, number of outpatient treatment visits, and expenditures.Results 
    The rate of outpatient treatment for depression increased from 2.37 per 100 persons in 1998 to 2.88 per 100 persons in 2007 (adjusted odds ratio [AOR], 1.18; 95% confidence interval [CI], 1.03-1.35). The percentage of treated patients who used antidepressants was little changed from 73.8% (1998) to 75.3% (2007) (AOR, 1.14; 95% CI, 0.85-1.51), but the percentage of those receiving psychotherapy declined from 53.6% (1998) to 43.1% (2007) (AOR, 0.71; 95% CI, 0.53-0.95). National expenditures for the outpatient treatment of depression increased from $10.05 billion to $12.45 billion (z = 1.73, P = .08). This was primarily driven by an increase in medication expenditures from $4.59 billion (1998) to $6.60 billion (2007) (z  = 2.88, P = .004), which in turn was related to an increase in Medicare expenditures for depression treatment from $0.52 billion (1998) to $2.25 billion (2007) (z = 5.62, P < .001).Conclusions 
    Rapid increases in depression treatment from 1987 to 1997 were followed by more modest increases during the following decade. Although there was little change in the proportion of patients receiving antidepressants, treatment with psychotherapy has declined.