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Use of Antidepressant Medications Common Among People With No Psychiatric Illness: Presented at CPA

By Thomas S. May

VANCOUVER -- September 8, 2008 -- Use of antidepressant medications is common among individuals who do not have any identifiable Axis I psychiatric disorders, according to results of a study presented here at the 58 Annual Conference of the Canadian Psychiatric Association (CPA).

"Anecdotal evidence suggests that many individuals in the general population may be taking antidepressants without possessing any indication for such treatment, according to accepted medical guidelines," said first author Jina Pagura, BSc(Hons), Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.

To examine the prevalence of antidepressant use, as prescribed by a physician, in the general population with no Axis I mental disorder diagnosis, Ms. Pagura and supervising investigator Jitender Sareen, MD, Department of Psychiatry, University of Manitoba, used 3 cross-sectional surveys of the US general population.

The cohort comprised 20,013 subjects 18 years and older. The average response rate to the surveys was 72.7%.

Mental disorders were assessed by trained lay interviewers using the Composite International Diagnostic Interview. Potential correlates of antidepressant use were also examined using logistic regression, including sociodemographic factors, distress, and past history of mental disorders.

An analysis of the results showed that among individuals who reported using an antidepressant in the previous year, more than 50% did not meet criteria for any of the diagnoses assessed. The researchers also found that these individuals were significantly more likely to be older, white, and female compared with those who took antidepressants and who also met criteria for a 12-month diagnosis and those who neither had a 12-month diagnosis nor took antidepressants.

These findings are important because the efficacy of antidepressant medications has not been tested among individuals with mild depression but only among those with severe major depressive disorder, said Ms. Pagura.

She also stressed that clinical practice guidelines do not suggest the use of antidepressants in many cases where they may be commonly used.

"Clinically, it is important for health practitioners to understand the prevalence of such antidepressant use, as it may encourage better diagnosis and treatment of these individuals, especially in terms of psychotherapeutic interventions for individuals with subdiagnostic symptoms or distress," Ms. Pagura concluded.


[Presentation title: Antidepressant Use in the Absence of Axis I Psychiatric Diagnoses in the General Population. Abstract P18]

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