Depression care among depressed adults with and without comorbid substance use disorders in the United States

Abstract

Among depressed adults in the United States, comorbid SUD modestly but significantly decreases the likelihood of receiving past-year depression care. Depressed young adults, men, racial/ethnic minorities, less educated individuals, uninsured adults, and never married adults are also at increased risk for not receiving depression care. Outreach efforts are needed to broaden access to depression care for these underserved adults.

Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States

“…This result is higher than the treatment rate in one recent study that used less specific measures to identify depression but is consistent with rates from other studies published in the last 4 years . The NESARC-III treatment rates are plausible given the extent of direct-to-consumer advertising of antidepressants and widespread distribution through primary care . However, with 30% of patients still untreated, improved treatment delivery for MDD remains needed; much distress or social or economic burden is avoidable through behavioral and pharmacologic MDD treatment .…”

“…78 The likelihood of treatment for depression is reduced in those with SUDs. 79 However, dual-focused treatment is more effective when 2 disorders are present. 70 Therefore, clinician education and training in dual-disorder screening and treatment should be prioritized.…”

“…81,82 The NESARC-III treatment rates are plausible given the extent of direct-toconsumer advertising of antidepressants 83 and widespread distribution through primary care. 79 However, with 30% of patients still untreated, improved treatment delivery for MDD remains needed; much distress or social or economic burden is avoidable through behavioral and pharmacologic MDD treatment. 12,84 Studies should examine the demographic and clinical correlates of treatment and whether these factors are changing over time.…”

“…Evidence suggests that efforts to self-manage depression with cannabis are increasing (also Aaron L. Sarvet, MPH, written communication, January 2, 2018) despite lack of evidence that cannabinoids are effective for this purpose; prospectively, cannabis worsens the course of depressive disorders . The likelihood of treatment for depression is reduced in those with SUDs . However, dual-focused treatment is more effective when 2 disorders are present .…”

Circadian Characteristics in Patients under Treatment for Substance Use Disorders and Severe Mental Illness (Schizophrenia, Major Depression and Bipolar Disorder)

“…Moreover, for patients with SZ+ and BD+, the outpatient treatment modality was predominant, while for patients with MDD+ the residential and therapeutic community treatment was more frequent. On the other hand, the mean age of SMI onset was earlier for the SZ+ group, this observation has been associated with a worse clinical, cognitive and functional prognosis [ 60 , 66 , 67 ]. As in previous studies, our sample presented similarities in psychiatric family history, medical disease comorbidity and previous suicide attempts [ 68 , 69 , 70 ].…”