Infrequent use of antidepressants in depressed individuals (an interview and prescription database study in a defined Swedish population 2001-2002).
OBJECTIVE
To investigate whether antidepressants are over-used, under-used, or misused, by determining to what extent the depressed individuals in a defined population are treated with antidepressant medication and, from the other end, to what extent prescribed antidepressants are aimed for the treatment of depression.


METHODS
From an individual based prescription database in the County of Jämtland, 2048 individuals representative for the general population were selected. The presence of current depression in these individuals was screened by a mailed self-screening questionnaire. Individuals with depression according to the questionnaire were interviewed by a psychiatrist using a structured interview (SCAN) to confirm the diagnosis. Their use of antidepressants was obtained from the prescription database.


RESULTS
Sixty-two (4.5%) out of 1375 were diagnosed with depression and 17 (27%) of these were taking an antidepressant. In addition 44 individuals, currently not depressed, were taking antidepressants. Twenty-five of these were interviewed per telephone and it was found that the indications for 18 of them were continuation treatment of depression, and for seven of them pain, sleep disturbance or anxiety.


CONCLUSIONS
Antidepressants appear to be under-used in the population. Only one in four of the depressed individuals was treated with antidepressant medication. Those who had antidepressant medication without being currently depressed had, with few exceptions, either continuation treatment for depression in remission or treatment on other approved indications.
Henriksson
S
S
Karolinska Institute, Clinical neuroscience, Section psychiatry, Karolinska University Hospital, Huddinge, Sweden. svante.henriksson@ki.se
Asplund
R
R
Boëthius
G
G
Hällström
T
T
Isacsson
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019992:Databases as Topic; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010507:Periodicity; D015995:Prevalence; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
D000928:Antidepressive Agents