Antidepressant Use in Black and White Populations in the United States

Abstract

Objective-The study objective was to estimate the prevalence and correlates of antidepressant use by black and white Americans.Methods-Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) were analyzed to calculate nationally representative estimates of antidepressant use by black and white Americans. Setting-The 48 coterminous United States was the setting.Participants-Household residents ages 18 years and older (N=9,723) participated in the study.Main Outcomes-The primary outcome was past-year antidepressant use (n=1,004).Results-Among individuals with 12-month depressive and anxiety disorders (n=516), blacks (14.6%) had significantly lower (p < 0.001) antidepressant use than whites (32.4%). Depression severity was significantly associated with higher antidepressant use for whites, but not blacks. Psychiatric disorders and vascular disease significantly increased the odds of past-year antidepressant use. The increased prevalence of antidepressant use associated with vascular disease was independent of diagnosable psychiatric disorders. Among respondents not meeting criteria for 12-month depressive and anxiety disorders, lifetime depressive and anxiety disorders and vascular disease significantly increased the odds of antidepressant use.Conclusions-Few white and fewer black Americans with depressive and anxiety disorders receive antidepressant treatment. Higher depression severity was associated with more antidepressant use for whites, but not blacks. Antidepressant use was associated with medical conditions related to vascular disease, and these medical conditions were independent of coexisting psychiatric conditions. The results also indicate that many antidepressants are used for maintenance pharmacotherapy for

Difference by sex but not by race/ethnicity in the visceral adipose tissue-depressive symptoms association: The Multi-Ethnic Study of Atherosclerosis

“…However, the effects of antidepressant use in this relationship as a covariate or as part of the definition of EDS may be of particular importance as excluding antidepressant use may misclassify once severely depressed individuals who were treated and controlled at the time of assessment, but whose prior depression has already influenced VAT, as not having EDS. As antidepressant use has also been more common among Whites than ethnic minorities (Gonzalez et al, 2008, 2009, 2010), exclusion of medication use to define EDS may also misclassify a large portion of this cohort. Another consideration, however, is that anti-depressants can be prescribed for indications other than depression, resulting in another source of misclassification.…”

Racial Differences in Antidepressant Use Among Older Home Health Care Patients

“…Older community dwelling blacks have nearly half the odds of using antidepressants when compared to whites (7). The goal of this study is to examine the prevalence of diagnosed depression, rates of antidepressant use, and the potential racial effect among older homecare patients.…”

Measuring Racial/Ethnic Disparities across the Distribution of Health Care Expenditures

“…Studies measuring quality of care have identified higher rates of attrition from treatment among racial/ethnic minorities, 10 with fewer psychotherapy treatment sessions and lack of prescription drug use for individuals diagnosed with depression 11,12 and schizophrenia, 13 and disparities in receipt of the best available depression treatments. 7,14 Racial/ethnic disparities also exist in the use of psychotropic medications, including selective serotonin reuptake inhibitors (SSRIs) 11,15,16 for depression, atypical antipsychotics (particularly clozapine) for schizophrenia, 17–21 and antipsychotics and mood stabilizers for bipolar disorder. 21,22 …”