Major Depression on the Rise in the United States

March 1, 2007

Treatment interventions via telephone, Internet, and through other telemedical services are gaining popularity, especially in rural areas where licensed clinicians might not be available. Dr Per Carlbring and colleagues recently evaluated a 10-week, Internet-based, self-help program with weekly telephone calls for patients who had panic disorder with or without agoraphobia. The results were published in the December 2006 issue of the American Journal of Psychiatry.

Rates of major depression and of majordepression with comorbid substanceuse disorders are on the rise. Arecent review that was conducted byDr Wilson M. Compton and associatesfrom the National Institutes of Healthshowed that the prevalence rates ofmajor depression increased in patientswith and without a substance use disorderfrom 3.33% in 1991-1992 to7.06% in 2001-2002. The results of thesurvey were published in the December2006 issue of The American Journalof Psychiatry.

The researchers used data from 2major, nationally representative surveys:the National Longitudinal AlcoholEpidemiologic Survey (N =42,862), conducted in 1991-1992, andthe National Epidemiologic Survey onAlcohol and Related Conditions (N =43,093), conducted in 2001-2002. Alldiagnoses were made based on datafrom the Alcohol Use Disorder andAssociated Disabilities InterviewSchedule-DSM-IV.

Increases in major depression, withor without a substance use disorder,were statistically significant for white,black, and Hispanic persons and for allage groups.

Rates of major depressive episodeswithin the past year in patients with acurrent substance use disorder increasedfrom 9.97% in 1991-1992 to15.06% in 2001-2002. Significant increaseswere reported in whites andblacks of every age group, including inwhite and black women. Young blackmen (aged 18 to 29 years) were the onlygroup in which a statistically significantincrease in depression could beexplained by an increase in co-occurringsubstance use disorders.

In persons without a substance usedisorder, the rates of depression increasedfrom 2.76% in 1991-1992 to6.23% in 2001-2002.

The authors noted that a generalchange in patients' willingness to reportdepressive symptoms is not likelyto explain the increased rates of depressionfound in the studies, and theysuggested that a number of environmentalfactors need to be studied toclarify their potential role in increasingthe rates. They also warned of potentiallyprofound economic and healthcare implications if rates continue torise at the same pace as did over thedecade studied.