Cited by 312Mental Health Treatment and AccessTreatment of Major DepressionPsychological Treatments and Disorders

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National Trends in the Treatment for Depression From 1998 to 2007

Marcus, Steven C., Olfson, Mark·2010·Archives of General Psychiatry

DOI 10.1001/archgenpsychiatry.2010.151

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Abstract

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.

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Authors: Marcus, S. C., & Olfson, M.
Affiliations: Philadelphia VA Medical Center (US)
ORCID: Marcus, Steven C.
Olfson, Mark
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 2010-12-06
Volume: 67
Issue: 12
Pages: 1265
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archgenpsychiatry.2010.151
OpenAlex: W2118772250
Cited by: 312
References: 51
Citations by year: 2026: 6 · 2025: 8 · 2024: 10 · 2023: 12 · 2022: 11 · 2021: 27 · 2020: 15 · 2019: 26 · 2018: 21 · 2017: 22 · 2016: 26 · 2015: 32 · 2014: 26 · 2013: 28 · 2012: 26
FWCI: 30.46
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: Agency for Healthcare Research and Quality (U18HS016097)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Keywords: depression, outpatient care, treatment trends, antidepressant use, psychotherapy, treatment costs, Medicare spending, health care utilization, Medical Expenditure Panel Survey, United States, mental health services, managed care
MeSH terms: Adult, Aged, Ambulatory Care, Antidepressive Agents, Depression, Major Depressive Disorder, Depressive Disorder, Health Expenditures, Female, Health Resources, Humans, Longitudinal Studies, Male, Middle Aged, Outpatients, Psychotherapy, United States

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