The impact of antidepressant treatment on population health: synthesis of data from two national data sources in Canada
Open accessAbstract
Background: In randomized, controlled trials, antidepressant medications have been shown to reduce the duration of major depressive episodes and to reduce the frequency of relapse during long-term treatment. The epidemiological impact of antidepressant use on episode duration and relapse frequency, however, has not been described. Methods: Data from two Canadian general health surveys were used in this analysis: the National Population Health Survey (NPHS) and the Canadian Community Health Survey (CCHS). The NPHS is a longitudinal study that collected data between 1994 and 2000. These longitudinal data allowed an approximation of episode incidence to be calculated. The cross-sectional CCHS allowed estimation of episode duration. The surveys used the same sampling frame and both incorporated a Short Form version of the Composite International Diagnostic Interview. Results: Episodes occurring in antidepressant users lasted longer than those in non-users. The apparent incidence of major depressive episodes among those taking antidepressants was higher than that among respondents not taking antidepressants. Changes in duration and incidence over the data collection interval were not observed. Conclusions: The most probable explanation for these results is confounding by indication and/or severity: members of the general population who are taking antidepressants probably have more highly recurrent and more severe mood disorders. In part, this may have been due to the use of a brief predictive diagnostic interview, which may be prone to detection of sub-clinical cases. Whereas antidepressant use increased considerably over the data-collection period, differences in episode incidence and duration over time were not observed. This suggests that the impact of antidepressant medications on population health may have been less than expected.
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Despite possible confounding by the possibility that antidepressants were prescribed to the most severe and recurring cases, the impact of antidepressants in the general population did not appear to be favorable.
“Even though the results might have been confounded by the possibility that AD were prescribed to the most severe and recurring cases, the impact of AD in the general population did not appear to be favorable.72”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [72]
In other longitudinal naturalistic studies involving all types of antidepressants, a higher incidence and longer duration of major depressive episodes was found in those who used antidepressants compared with those not taking those medications.
“In other longitudinal naturalistic studies involving all types of AD, a higher incidence and longer duration of episodes of major depression was found in those who used AD compared with those not taking those medications.72”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [72]
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- Authors
- Patten, S. B.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Patten, Scott B
- ORCID
- Patten, Scott B
- Venue
- Population Health Metrics
- Published
- 2004-11-01
- Volume
- 2
- Issue
- 1
- Pages
- 9-9
- ISSN
- 1478-7954 (ISSN-L)
- PMC
- PMC538292
- OpenAlex
- W1813416304
- Cited by
- 28
- References
- 16
- Citations by year
- 2024: 1 · 2022: 1 · 2020: 1 · 2018: 1 · 2015: 1 · 2013: 1 · 2012: 2
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Population Health Metrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Fondation pour la Recherche Médicale
- Canadian Institutes of Health Research
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- antidepressants, major depressive episode, episode duration, relapse, depression incidence, confounding by indication, mood disorders, subthreshold depression, population health, National Population Health Survey, Canadian Community Health Survey
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