The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index.
Treatment of Adult Depression in the United States
Open accessAbstract
IMPORTANCE: Despite recent increased use of antidepressants in the United States, concerns persist that many adults with depression do not receive treatment, whereas others receive treatments that do not match their level of illness severity. OBJECTIVE: To characterize the treatment of adult depression in the United States. DESIGN, SETTING, AND PARTICIPANTS: Analysis of screen-positive depression, psychological distress, and depression treatment data from 46 417 responses to the Medical Expenditure Panel Surveys taken in US households by participants aged 18 years or older in 2012 and 2013. MAIN OUTCOME AND MEASURES: Percentages of adults with screen-positive depression (Patient Health Questionnaire-2 score of ≥ 3) and adjusted odds ratios (AORs) of the effects of sociodemographic characteristics on odds of screen-positive depression; percentages with treatment for screen-positive depression and AORs; percentages with any treatment of depression and AORs stratified by presence of serious psychological distress (Kessler 6 scale score of ≥13); and percentages with depression treatment by health care professional group (psychiatrists, other health care professionals, and general medical providers); and type of depression treatment (antidepressants, psychotherapy, and both) all stratified by distress level. RESULTS: Approximately 8.4% (95% CI, 7.9-8.8) of adults screened positive for depression, of which 28.7% received any depression treatment. Conversely, among all adults treated for depression, 29.9% had screen-positive depression and 21.8% had serious psychological distress. Adults with serious compared with less serious psychological distress who were treated for depression were more likely to receive care from psychiatrists (33.4% vs 17.3%, P < .001) or other mental health specialists (16.2% vs 9.6%, P < .001), and less likely to receive depression care exclusively from general medical professionals (59.0% vs 74.4%, P < .001). They were also more likely to receive psychotherapy (32.5% vs 20.6%, P < .001), though not antidepressant medications (81.1% vs 88.6%, P < .001). CONCLUSIONS AND RELEVANCE: Most US adults who screen positive for depression did not receive treatment for depression, whereas most who were treated did not screen positive. In light of these findings, it is important to strengthen efforts to align depression care with each patient's clinical needs.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“The NESARC-III treatment rates are plausible given the extent of direct-toconsumer advertising of antidepressants 83 and widespread distribution through primary care.79”
From Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [79]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Approximately 90% of suicides have a current diagnosable psychiatric disorder, most commonly a major depression that was untreated at time of death.(111, 143, 144)”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [111]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The greatest risk of suicidal behavior is after discharge from the emergency room (ER) or hospital inpatient units.(110–112)”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [111]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The greatest risk for repeating a suicide attempt is in the month following an index attempt, and particularly after discharge of a psychiatric patient from an emergency department or inpatient hospital unit.(110–112)”
From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [111]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The likelihood of treatment for depression is reduced in those with SUDs.79”
From Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [79]
Experimental — accuracy not yet measured
In the citing paper
“However, there are several previous studies using the MEPS and their results are comparable with results generated from other sources (42–44).”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
KESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988
The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2003) · Medical Care · doi:10.1097/01.mlr.0000093487.78664.3c · Cited by 6,359
Screening for serious mental illness in the general population
Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S.-L. T., Manderscheid, R. W., Walters, E. E., et al. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.2.184 · Cited by 5,692
Trivedi, M. H., Rush, A. J., Wisniewski, S. R., Nierenberg, A. A., Warden, D., Ritz, L., Norquist, G., Howland, R. H., Lebowitz, B., McGrath, P. J., et al. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.1.28 · Cited by 3,879
Socioeconomic inequalities in depression: a meta-analysis
Lorant, V. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwf182 · Cited by 2,603
Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008) · PLoS Medicine · doi:10.1371/journal.pmed.0050045 · Cited by 2,442
Unützer, J., Katon, W., Callahan, C. M., Williams, Jr., Hunkeler, E., Harpole, L., Hoffing, M., Della Penna, R. D., Noël, P. H., Lin, E. H. B., et al. (2002) · JAMA · doi:10.1001/jama.288.22.2836 · Cited by 2,405
Cooney, G. M., Dwan, K., Greig, C. A., Lawlor, D. A., Rimer, J., Waugh, F. R., McMurdo, M., & Mead, G. E. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004366.pub6 · Cited by 1,834
Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.10.1097 · Cited by 1,645
Detecting and monitoring depression with a two-item questionnaire (PHQ-2)
Löwe, B., Kroenke, K., & Gräfe, K. (2005) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2004.09.006 · Cited by 1,473
Kessler, R. C., Green, J. G., Gruber, M. J., Sampson, N. A., Bromet, E., Cuitan, M., Furukawa, T. A., Gureje, O., Hinkov, H., Hu, C., et al. (2010) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.310 · Cited by 1,434
Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement
Siu, A. L., and the US Preventive Services Task Force (USPSTF), Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., García, F. A. R., Gillman, M., Herzstein, J., et al. (2016) · JAMA · doi:10.1001/jama.2015.18392 · Cited by 1,407
PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder
Gelenberg, A. J., Freeman, P. B., Markowitz, J. C., Rosenbaum, J. F., Thase, M. E., Trivedi, M. H., & Rhoads, R. S. (2010) · Cited by 1,372
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.603 · Cited by 1,325
Self-citationValidation of PHQ-2 and PHQ-9 to Screen for Major Depression in the Primary Care Population
Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., Falloon, K., & Hatcher, S. (2010) · The Annals of Family Medicine · doi:10.1370/afm.1139 · Cited by 1,279
Clinical diagnosis of depression in primary care: a meta-analysis
Mitchell, A. J., Vaze, A., & Rao, S. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60879-5 · Cited by 1,251
The National Collaborating Centre for Mental Health
Kendall, T., & Pilling, S. (2004) · UCL Discovery (University College London) · Cited by 840
Cramer, H., Lauche, R., Langhorst, J., & Dobos, G. (2013) · Depression and Anxiety · doi:10.1002/da.22166 · Cited by 708
Sakurai, K., Nishi, A., Kondo, K., Yanagida, K., & Kawakami, N. (2011) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2011.02236.x · Cited by 649
Woltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. S. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2012.11111616 · Cited by 603
Screening for Depression in Adults: U.S. Preventive Services Task Force Recommendation Statement
U.S. Preventive Services Task Force* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-11-200912010-00006 · Cited by 581
Barth, J., Munder, T., Gerger, H., Nüesch, E., Trelle, S., Znoj, H., Jüni, P., & Cuijpers, P. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001454 · Cited by 569
Nelson, J. C., & Papakostas, G. I. (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09030312 · Cited by 552
Lam, R. W., Kennedy, S. H., Grigoriadis, S., McIntyre, R. S., Milev, R., Ramasubbu, R., Parikh, S. V., Patten, S. B., & Ravindran, A. V. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.041 · Cited by 431
Changing Profiles of Service Sectors Used for Mental Health Care in the United States
Wang, P., Demler, O., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.7.1187 · Cited by 366
Self-citationMead, G. E., Morley, W., Campbell, P., Greig, C. A., McMurdo, M., & Lawlor, D. A. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004366.pub4 · Cited by 364
Fournier, J. C., DeRubeis, R. J., Shelton, R. C., Hollon, S. D., Amsterdam, J. D., & Gallop, R. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0015401 · Cited by 340
National trends in the treatment for depression from 1998 to 2007
Marcus, S. C., & Olfson, M. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.151 · Cited by 312
Self-citationDepression treatment preferences in older primary care patients
Gum, A. M., Areán, P. A., Hunkeler, E., Tang, L., Katon, W., Hitchcock, P., Steffens, D. C., Dickens, J., & Unützer, J. (2006) · The Gerontologist · doi:10.1093/geront/46.1.14 · Cited by 288
Cuijpers, P., Dekker, J., Hollon, S. D., & Andersson, G. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.09r05021 · Cited by 261
Mojtabai, R., & Olfson, M. (2014) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13m08443 · Cited by 247
Self-citationBarbui, C., Cipriani, A., Patel, V., Ayuso‐Mateos, J. L., & van Ommeren, M. (2011) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.076448 · Cited by 216
Driessen, E., Cuijpers, P., Hollon, S. D., & Dekker, J. J. M. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020570 · Cited by 208
Psychotherapy for subclinical depression: meta-analysis
Cuijpers, P., Koole, S. L., van Dijke, A., Roca, M., Li, J., & Reynolds, C. F. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.113.138784 · Cited by 193
Antidepressants plus benzodiazepines for major depression
Furukawa, T. A., Streiner, D., Young, L. T., & Kinoshita, Y. (2001) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001026 · Cited by 161
Patten, S. B., Kennedy, S. H., Lam, R. W., O'Donovan, C., Filteau, M. J., Parikh, S. V., & Ravindran, A. V. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.044 · Cited by 148
Benzodiazepine Use Among Depressed Patients Treated in Mental Health Settings
Valenstein, M. M., Taylor, K. K., Austin, K., Kales, H. C., McCarthy, J. F., & Blow, F. C. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.4.654 · Cited by 136
Craighead, W. E., & Dunlop, B. W. (2011) · Annual Review of Psychology · doi:10.1146/annurev.psych.121208.131653 · Cited by 130
Pathways to the First Contact with Specialist Mental Health Care
Steel, Z., Mcdonald, R., Silove, D. M., Bauman, A. E., Sandford, P., Herron, J., & Minas, I. H. (2006) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2006.01801.x · Cited by 104
Mojtabai, R. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000345968 · Cited by 101
Feltz-Cornelis, C. M. V. D., Os, T. W. D. P. V., van Marwijk, H., & Leentjens, A. F. G. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.10.012 · Cited by 99
Anticonvulsants in the Treatment of Major Depressive Disorder
Vigo, D., & Baldessarini, R. J. (2009) · Harvard Review of Psychiatry · doi:10.1080/10673220903129814 · Cited by 69
von Wolff, A., Hölzel, L. P., Westphal, A., Härter, M. C., & Kriston, L. (2012) · BMC Psychiatry · doi:10.1186/1471-244x-12-61 · Cited by 64
Lee, S. Y., Franchetti, M. K., Imanbayev, A., Gallo, J. J., Spira, A. P., & Lee, H. B. (2012) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2012.03.003 · Cited by 63
Antidepressants Are Not Overprescribed for Mild Depression
Simon, G. E., Rossom, R. C., Beck, A. L., Waitzfelder, B. E., Coleman, K. J., Stewart, C. C., Operskalski, B. H., Penfold, R. B., & Shortreed, S. M. (2015) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.14m09162 · Cited by 27
Wun, L., Ezzati‐Rice, T. M., Díaz-Tena, N., & Greenblatt, J. (2007) · Statistics in Medicine · doi:10.1002/sim.2809 · Cited by 27
Nelson, J. C., & Papakostas, G. I. (2010) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/foc.8.4.foc570 · Cited by 23
Bauer, A. M., Azzone, V., Alexander, L., Goldman, H. H., Unützer, J., & Frank, R. G. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2011.08.019 · Cited by 21
Gilman, S. E., Fitzmaurice, G. M., BRUCE, M. L., Have, T. T., Glymour, M. M., Carliner, H., Alexopoulos, G. S., Mulsant, B. H., Reynolds, C. F., & Cohen, A. (2012) · Epidemiology · doi:10.1097/ede.0b013e3182762403 · Cited by 16
Pathways to the first contact with specialist mental health care
Steel, Z., McDonald, R., Silove, D. M., et al. (2006) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.2006.01801.x · Cited by 16
Flagged first, then by citations
Research works printed but not linked: 1
- [35]35. Arean PA, Hegel MT, Reynolds CF. Treatment depression in older medical patients with psychotherapy. J Clin Geropsychol. 2001;7:93-104.
Cited by
Sorted by citations
Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States
Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F. (2018) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.4602 · Cited by 1,737
Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review
Mann, J. J., Michel, C. A., & Auerbach, R. P. (2021) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20060864 · Cited by 655
Treatment resistant depression: A multi-scale, systems biology approach
Akil, H., Gordon, J. A., Hen, R., Javitch, J. A., Mayberg, H. S., McEwen, B. S., Meaney, M. J., & Nestler, E. J. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.08.019 · Cited by 463
Intergenerational Transmission of Depression
Goodman, S. H. (2020) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-071519-113915 · Cited by 297
Kroenke, K., & Unutzer, J. (2017) · Journal of General Internal Medicine · doi:10.1007/s11606-016-3967-9 · Cited by 231
Metadata
- Authors
- Olfson, M., Blanco, C., & Marcus, S. C.
- Affiliations
- New York State Psychiatric Institute (US)
- National Institute on Drug Abuse (US)
- University of Pennsylvania (US)
- Corresponding author
- Olfson, Mark
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2016-10-01
- Volume
- 176
- Issue
- 10
- Pages
- 1482
- ISSN
- 2168-6106 (ISSN-L)
- OpenAlex
- W2516765934
- Cited by
- 352
- References
- 51
- Citations by year
- 2026: 21 · 2025: 34 · 2024: 21 · 2023: 40 · 2022: 27 · 2021: 48 · 2020: 48 · 2019: 35 · 2018: 40 · 2017: 36
- FWCI
- 58.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality
- National Institute on Drug Abuse
- 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
- adult depression, depression treatment, antidepressants, psychotherapy, serious psychological distress, underdiagnosis of depression, access to mental health care, psychiatrists, sociodemographic disparities, United States adults, Medical Expenditure Panel Survey, Patient Health Questionnaire, Kessler 6 scale, mental health service utilization
- MeSH terms
- Adolescent, Adult, Aged, Antidepressive Agents, Depression, Drug Utilization, Educational Status, Female, Humans, Male, Mass Screening, Middle Aged, Psychiatry, Psychotherapy, Stress, Psychological, Antipsychotic Agents, Anti-Anxiety Agents, United States, Medically Uninsured, Marital Status, Insurance Coverage, Health Care Surveys, Young Adult, General Practitioners
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
