Frequency and Adequacy of Depression Treatment in a Canadian Population Sample

Abstract

Objective: Population-based data about depression treatment are largely restricted to estimates of the frequency of antidepressant (AD) use. Such frequencies are difficult to interpret in the absence of information about dosages, reasons for taking the medications, and participation in nonpharmacologic treatment. The objective of this study was to describe the pattern of treatment for major depression (MD) in Alberta. Method: Telephone survey methods were employed. Random digit dialing was used to select a sample of 3345 household residents aged 18 to 64 years in Alberta. A computer-assisted telephone interview that included the Mini Neuropsychiatric Diagnostic Interview and questions about pharmacotherapy and psychotherapy was administered. Estimates were weighted for design features and population demographics. Results: The point prevalence of MD was 4.4% (95% confidence interval [CI], 3.4% to 5.5%), and the overall prevalence of current AD use was 7.4% (95%CI, 6.2% to 8.6%). The ADs taken most commonly, serotonin-specific reuptake inhibitors, were taken at therapeutic dosages 87.4% of the time. Most (80.7%) of those taking ADs reported taking them for more than 1 year. The frequency of receiving counselling, psychotherapy, or talk therapy was 3.9% overall and 14.3% in respondents with MD. However, most of these subjects were unable to name the type of counselling they were receiving. Conclusions: When compared with previous estimates, these results suggest continued progress in the delivery of evidence-based care to the population. There is room for additional improvement, especially in the provision of nonpharmacologic treatment.