title: Depression and remoteness from health services in South Australia.
abstract: OBJECTIVE
  To determine whether the prevalence of depression, its associated quality of life, treatment and mental health literacy about depression varied according to accessibility to health services.
  
  
  METHODS
  Face-to-face interviews with a random and representative sample of the South Australian population (aged >or= 15 years) were conducted between March and June 2004, with the respondents stratified using the Accessibility and Remoteness Index of Australia into categories of 'highly accessible', 'accessible', and 'moderately accessible and remote'.
  
  
  RESULTS
  From 4700 households selected, 3015 participants were interviewed (65.9% response rate). The prevalence of major depression and other depressions was not significantly different between each of the categories, although there was a trend for those from moderately accessible and remote areas to be less depressed overall. A significantly lower proportion of respondents from moderately accessible and remote locations reported that they had family or close friends who had suffered from symptoms consistent with depression, or that they had ever had treatment for those symptoms. However, there was no significant difference between the groups in those who had ever had or who were currently taking antidepressant medication. For those who were depressed, a significantly higher proportion from the accessible, and moderately accessible and remote regions had seen a community or district health service, social worker or other counsellor as compared with those from the highly accessible area.
  
  
  CONCLUSIONS
  These findings indicate that depression is no more prevalent in less accessible regions of South Australia, and that when it is present, its treatment, in terms of antidepressants, which can be considered as a proxy marker for the overall management of depression, is similar to treatment in more accessible areas.
authors.affiliation: University of Adelaide, Adelaide, South Australia, Australia. robert.goldney@adelaide.edu.au
authors.forename: Robert D
authors.initials: RD
authors.lastname: Goldney
authors.forename: Anne W
authors.initials: AW
authors.lastname: Taylor
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Bain
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010353:Patient Education as Topic; D011159:Population Surveillance; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D019035:Rural Health Services / Q000458:organization & administration*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013021:South Australia / Q000453:epidemiology; D011795:Surveys and Questionnaires