Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-24T00:14:27.365Z Has data issue: false hasContentIssue false
  • English
  • Français

Consensus Statement: The National Depressive and Manic-Depressive Association Consensus Statement on the Undertreatment of Depression

Published online by Cambridge University Press:  07 November 2014

Robert M. A. Hirschfeld ,
Martin B. Keller ,
Susan Panico ,
Bernard S. Arons ,
David Barlow ,
Frank Davidoff ,
Jean Endicott ,
Jack Froom ,
Michael Goldstein  and
Jack M. Gorman
...Show all authors
Get access Rights & Permissions [Opens in a new window]

Abstract

A consensus conference on the reasons for the undertreatment of depression was organized by the National Depressive and Manic Depressive Association (NDMDA) on January 17–18,1996. The target audience included health policymakers, clinicians, patients and their families, and the public at large. Six key questions were addressed: (1) Is depression undertreated in the community and in the clinic? (2) What is the economic cost to society of depression? (3) What have been the efforts in the past to redress undertreatment and how successful have they been? (4) What are the reasons for the gap between our knowledge of the diagnosis and treatment of depression and actual treatment received in this country? (5) What can we do to narrow this gap? (6) What can we do immediately to narrow this gap?

Type
Feature Articles
Information
CNS Spectrums , Volume 2 , Issue 2: Migraine: Pathophysiology & Comorbidity: A Window into Psychiatry and Neurology , February 1997 , pp. 39 - 50
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2. Keller, MB, Harrison, W, Fawcett, JA, et al. , Treatment of chronic depression with sertraline and imipramine: preliminary blinded response rates and high rates of undertreatment in the community. Psychopharmacol Bull. 1995;31:205–212.Google ScholarPubMed
3. Kocsis, JH, Friedman, RA, Markowitz, JC, et al. , Maintenance therapy for chronic depression: a controlled clinical trial of desipramine. Arch Gen Psychiatry. In press.Google Scholar
4. Shelton, RC, Davidson, J, Yonkers, K, et al. , The undertreatment of dysthymia. J Clin Psychiatry. In press.Google Scholar
5. Kocsis, JH, Frances, AJ, Voss, C, Mann, JJ, Mason, BJ, Sweeney, J. Imipramine treatment for chronic depression. Arch Gen Psychiatry. 1988;45:253–257.CrossRefGoogle ScholarPubMed
6. Kessler, RC, McGonagle, KA, Zhao, , et al. , Life time and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.CrossRefGoogle Scholar
7. Regier, DA, Narrow, WE, Rae, DS, Manderscheid, RW, Locke, BZ, Goodwin, FK. The de facto US Mental and Addictive Disorders Service System: Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993;50:84–94.CrossRefGoogle Scholar
8. Shapiro, S, Skinner, EA, Kessler, LG, et al. , Utilization of health and mental health services: three Epidemiological Catchment Area sites. Arch Gen Psychiatry. 1984;41:971–978.CrossRefGoogle ScholarPubMed
9. Cross-National Collaborative Group. The changing rate of major depression. JAMA. 1992;268:3098–3105.CrossRefGoogle Scholar
10. Klerman, GL, Weissman, MM. Increasing rates of depression. JAMA. 1989;261:2229–2235.CrossRefGoogle ScholarPubMed
11. Robins, LN, Regier, DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York, NY: Free Press; 1991.Google Scholar
12. Keller, MB, Klerman, GL, Lavori, PW, Fawcett, JA, Coryell, W, Endicott, J. Treatment received by depressed patients. JAMA. 1982;248:1848–1855.CrossRefGoogle ScholarPubMed
13. Keller, MB, Lavori, PW, Klerman, GL, et al. , Low levels and lack of predictors of somatotherapy and psychotherapy received by depressed patients. Arch Gen Psychiatry. 1986;43:458–466.CrossRefGoogle ScholarPubMed
14. Simon, GE, von Korff, M. Recognition, management, and outcomes of depression in primary care. Arch Fam Med. 1995;4:99–105.CrossRefGoogle ScholarPubMed
15. Coyne, JC, Fechner-Bates, S, Schwenk, TL. Prevalence, nature, and comorbidity of depressive disorders in primary care. Gen Hosp Psychiatry. 1994;16:267–276.CrossRefGoogle ScholarPubMed
16. Katon, W, von Korff, M, Lin, E, Bush, T, Ormel, J. Adequacy and duration of antidepressant treatment in primary care. Med Care. 1992;30:67–76.CrossRefGoogle ScholarPubMed
17. Goethe, JW, Szarek, BL, Cook, WL. A comparison of adequately vs inadequately treated depressed inpatients. J Nerv Ment Dis. 1988;176:464–470.CrossRefGoogle Scholar
18. Keller, MB. Undertreatment of major depression. Psychopharmacol Bull. 1988;24:75–80.Google ScholarPubMed
19. Keller, MB, Klerman, GL, Lavori, PW, Coryell, W, Endicott, J, Taylor, J. Long-term outcome of episodes of major depression: clinical and public health significance. JAMA. 1984;252:788–792.CrossRefGoogle ScholarPubMed
20. Keller, MB, Lavori, PW, Lewis, CE, Klerman, GL. Predictors of relapse in major depressive disorder. JAMA. 1983;250:3299–3304.CrossRefGoogle ScholarPubMed
21. Keller, MB, Lavori, PW, Rice, J, Coryell, W, Hirschfeld, RMA. The persistent risk of chronicity in recurrent episodes of nonbipolar major depressive disorder: a prospective followup. Am J Psychiatry. 1986;143:24–28.Google Scholar
22. Finkelstein, SN, Berndt, ER, Greenberg, PE. Economics of Depression: A Summary and Review. Prepared for the National Depressive and Manic-Depressive Association-sponsored Consensus Conference on the Undertreatment of Depression, January 17–18, 1996.Google Scholar
23. Greenberg, PE, Stiglin, LE, Finkelstein, SN, Berndt, ER. The economic burden of depression in 1990. J Clin Psychiatry. 1993;54:405–418.Google ScholarPubMed
24. Stoudemire, A, Frank, R, Hedemark, N, Kamlet, M, Blazer, D. The economic burden of depression. Gen Hosp Psychiatry. 1986;8:387–394.CrossRefGoogle ScholarPubMed
25. Hall, RCW, Wise, MG. The clinical and financial burden of mood disorders. Psychosomatics. 1995; 36:S11–S18.CrossRefGoogle ScholarPubMed
26. Greenberg, PE, Kessler, RC, Nells, TL, Finkelstein, SN, Berndt, ER. Depression in the workplace: an economic perspective. In: Feighner, JP, Boyer, WF. Selective Serotonin Re-uptake Inhibitors: Advances in Basic Research and Clinical Practice. 2nd ed. New York, NY: John Wiley & Sons Ltd; 1996.Google Scholar
27. Conti, DJ, Burton, WN. Economic impact of depression in a workplace. J Occup Environ Med. 1994;36:983–988.Google Scholar
28. Wells, KB, Stewart, A, Hays, RD, et al. , The functioning and well being of depressed patients: results from the Medical Outcomes Study. JAMA. 1989;262:914–919.CrossRefGoogle ScholarPubMed
29. Sturm, R, Wells, K. How can care for depression become more cost-effective? JAMA. 1995;273:51–58.CrossRefGoogle ScholarPubMed
30. Mintz, J, Mintz, LI, Arruda, MJ, Hwang, SS. Treatment of depression and the functional capacity to work. Arch Gen Psychiatry. 1992;49:761–768.CrossRefGoogle ScholarPubMed
31. Rupp, A. The economic consequences of not treating depression. Br J Psychiatry. 1995;166(suppl):29–33.CrossRefGoogle Scholar
32. National Mental Health Association's Public Campaign, National Public Education Campaign on Clinical Depression (NPECCD). Advertising and media (national and local) April 1993; material distribution April 1993-present; local campaigns, January 1993-present.Google Scholar
33. Endicott, J, Blumenthal, R. Barriers to seeking treatment for major depression. Presented at the Annual Scientific Meeting of the New York State Office of Mental Health, Albany, NY, December 1995.Google Scholar
34. Jarrett, RB, Rush, AJ. Short-term psychotherapy of depressive disorders: current status and future directions. Psychiatry. 1994;57:115–132.CrossRefGoogle ScholarPubMed
35. McFarland, BH. Cost effectiveness considerations for managed care systems: treating depression in primary care. Am J Med. 1994;97(suppl 6A): 47S–57S.CrossRefGoogle ScholarPubMed
36. Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571.CrossRefGoogle ScholarPubMed
37. Katon, W, von Korff, M, Lin, E,, et al. , Collaborative management to achieve treatment guidelines: impact on depression in primary care. JAMA. 1995;273:1026–1031.CrossRefGoogle ScholarPubMed
38. Health Plan Employer Data and Information Set. Washington, DC: National Committee for Quality Assurance; July 1996.Google Scholar