By Steven Reinberg
MONDAY, Aug. 29, 2016 (HealthDay News) — Most American adults who suffer from depression aren’t getting treatment, a new study finds.
After screening survey data on more than 46,000 people, researchers found that 8 percent had depression, but only a third were being treated for the mood disorder.
The reasons why were varied.
“Some adults who experience depressive symptoms do not believe they are significant and require medical attention, or that they could benefit from treatment,” said lead researcher Dr. Mark Olfson.
For others, stigma or shame interferes with a desire to get professional help, said Olfson, a professor of psychiatry at the College of Physicians and Surgeons of Columbia University in New York City.
“In still other cases, the medical visits are oriented around more pressing and urgent medical problems, and the clinical opportunities to detect depression are missed,” he said.
The survey also found that some patients are overtreated with antidepressants. But, the percentage of people who fall into that category couldn’t be determined from the study data, he said.
“Some patients with less prominent, milder forms of depression may request and receive antidepressants, despite evidence that these medications have little or no therapeutic benefit for mild depression,” Olfson said.
While some Americans view antidepressants as stigmatizing, others see them as options to enhance personal and social well-being, and “as providing benefits that are well beyond their clinically approved uses,” Olfson noted.
Also, doctors sometimes keep patients on antidepressants, including those without a history of severe depression, “for years after their depression has resolved,” he said.
Olfson and his colleagues found that among all surveyed patients treated for depression, 30 percent were depressed, based on the results of screening, and 22 percent were suffering from serious psychological distress.
The most common treatments for depression were antidepressants and psychotherapy. Depressed patients were more likely to be treated by a primary care doctor, while those with serious psychological distress were more likely to be treated by a psychiatrist, the researchers found.
“However, over half of Americans with severe psychological distress were not seen by a psychiatrist, psychologist or another mental health professional,” Olfson said.
Patients with Medicare and Medicaid were more likely to be treated for depression, while uninsured patients and minorities were least likely to get treatment, he said.
One expert said the findings highlight shortcomings in how depression is both diagnosed and treated.
“Despite our best efforts, we still have a long way to go when it comes to bridging the gap between our evidence-based treatments for depression and the people who need them most,” said Simon Rego, chief psychologist at Montefiore Medical Center/Albert Einstein College of Medicine in New York City.
The new study offers data that can help bridge this gap, he added.
“For example, we should tailor our intervention efforts by focusing on increasing the integration of mental health services into primary care,” Rego said. “This should help improve access to care in disadvantaged populations, as well as improve awareness of treatment options.”
The study was published Aug. 29 in the journal JAMA Internal Medicine. It relied on self-reported information, which can sometimes be inaccurate, the researchers noted.
View Article Sources SOURCES: Mark Olfson, M.D., M.P.H., professor, psychiatry, College of Physicians and Surgeons of Columbia University, New York City; Simon Rego, Psy.D., chief psychologist, Montefiore Medical Center/Albert Einstein College of Medicine, New York City; Aug. 29, 2016, JAMA Internal Medicine, online
Steven Reinberg, Mtaalamu wa Ugonjwa wa Kihispania, anasema kuwa watu wazima wengi wa Marekani ambao wanakabiliwa na unyogovu hawapati matibabu, utafiti mpya unaonyesha. Baada ya kuchunguza takwimu za uchunguzi wa watu zaidi ya 46,000, watafiti walipata kwamba asilimia 8 walikuwa na mshuko wa moyo, lakini thuluthi moja tu walikuwa wakitibiwa kwa sababu ya ugonjwa huo. Sababu zilikuwa mbalimbali. "Watu wazima fulani wanaopata dalili za kushuka moyo hawaamini kwamba dalili hizo ni kubwa na zinahitaji matibabu, au kwamba wanaweza kufaidika na matibabu", akasema Mark Olfson, mkurugenzi wa utafiti huo. "Kwa wengine, aibu au aibu huingilia tamaa ya kupata msaada wa kitaaluma, ""alisema Olfson, profesa wa magonjwa ya akili katika Chuo Kikuu cha Madaktari na Madaktari wa Upasuaji cha Chuo Kikuu cha Columbia huko New York." "Katika visa vingine, ziara za matibabu huelekezwa kwa matatizo ya matibabu ya haraka na ya haraka, na fursa za kliniki za kugundua unyogovu hupotezwa", alisema. Uchunguzi huo pia uligundua kwamba baadhi ya wagonjwa hutumiwa kupita kiasi na dawa za kukandamiza hisia. Lakini, asilimia ya watu ambao huanguka katika jamii hiyo haikuweza kuamuliwa kutoka kwa data ya utafiti, alisema. "Watu wengine wenye aina ndogo za unyogovu wanaweza kuomba na kupokea dawa za kukandamiza, licha ya uthibitisho kwamba dawa hizi zina faida ndogo au hakuna matibabu kwa unyogovu mwepesi, ""Alisema Olfson." Wakati Wamarekani wengine wanaona dawa za kukandamiza kama stigmatizing, wengine kuwaona kama chaguzi za kuongeza ustawi wa kibinafsi na kijamii, na "kama kutoa faida ambazo ni mbali zaidi ya matumizi yao ya kliniki iliyokubaliwa", Olfson alibainisha. Pia, wakati mwingine madaktari huweka wagonjwa kwenye dawa za kukandamiza, kutia ndani wale wasio na historia ya kushuka moyo sana, "kwa miaka mingi baada ya kushuka moyo kwao kutatua", akasema. Olfson na wenzake walipata kwamba kati ya wagonjwa wote waliochunguzwa waliotibiwa kwa unyogovu, asilimia 30 walikuwa na unyogovu, kulingana na matokeo ya uchunguzi, na asilimia 22 walikuwa na shida kubwa ya kisaikolojia. Matibabu ya kawaida ya kushuka moyo yalikuwa dawa za kukandamiza mshuko wa moyo na tiba ya kisaikolojia. Wagonjwa walio na mshuko wa moyo walikuwa na uwezekano mkubwa wa kutibiwa na daktari wa huduma ya msingi, wakati wale walio na shida kubwa ya kisaikolojia walikuwa na uwezekano mkubwa wa kutibiwa na daktari wa akili, watafiti walipata. "Hata hivyo, zaidi ya nusu ya Wamarekani wenye shida kubwa ya kisaikolojia hawakuonekana na daktari wa akili, mwanasaikolojia au mtaalamu mwingine wa afya ya akili", Olfson alisema. Wagonjwa walio na Medicare na Medicaid walikuwa na uwezekano mkubwa wa kutibiwa kwa unyogovu, wakati wagonjwa wasio na bima na wachache walikuwa na uwezekano mdogo wa kupata matibabu, alisema. Mtaalamu mmoja alisema matokeo hayo yanaonyesha kasoro katika jinsi mshuko wa moyo unavyogunduliwa na kutibiwa. "Licha ya juhudi zetu, bado tuna njia ndefu ya kwenda linapokuja suala la kuziba pengo kati ya matibabu yetu ya unyogovu na watu wanaohitaji zaidi, ""alisema Simon Rego, mwanasaikolojia mkuu katika Kituo cha Matibabu cha Montefiore na Chuo cha Matibabu cha Albert Einstein huko New York City." Aliongeza kwamba utafiti huo mpya unatoa data zinazoweza kusaidia kuziba pengo hilo. "Kwa mfano, tunapaswa kurekebisha juhudi zetu za kuingilia kati kwa kuzingatia kuongeza ushirikiano wa huduma za afya ya akili katika huduma ya msingi", Rego alisema. "Hii inapaswa kusaidia kuboresha upatikanaji wa huduma katika idadi ya watu walio chini, na pia kuboresha ufahamu wa chaguzi za matibabu. ""Utafiti huo ulichapishwa Agosti 29 katika jarida la JAMA Internal Medicine." Watafiti hao walisema kwamba ripoti hiyo ilitegemea habari ambazo watu wenyewe waliripoti, ambazo nyakati nyingine zinaweza kuwa zisizo sahihi. "Mwanzoni mwa makala hii, tulizungumzia ""Mwanamke wa kwanza katika Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti wa Utafiti."""