Treatment-seeking behaviours for depression in the general population: results from the National Epidemiologic Survey on Alcohol and Related Conditions.
BACKGROUND
In light of the public health and clinical significance of major depression, treatment utilisation is an important issue. Epidemiological data is particularly useful for yielding accurate estimates of national trends; assessing unmet need in the population; and, informing mental health policy and focused planning of public health prevention and intervention programs.


METHODS
Based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), latent class analysis (LCA) was used to empirically identify and validate a typology of treatment-seeking behaviours for depression. Analyses were based on a subsample of individuals with a lifetime diagnosis of major depressive disorder (MDD).


RESULTS
A three-class solution emerged as the best-fitting model. The classes were labelled highly active treatment-seeking, partially active treatment-seeking, and inactive treatment-seeking. The classes were validated by reference to predisposing, enabling, and need factors associated with treatment utilisation.


CONCLUSIONS
Since information was retrieved by retrospective self-report it was not possible to corroborate information on treatment utilisation or medical conditions with independent clinical or administrative records. Reporting bias and recall error therefore cannot be ruled out. Also, given that the NESARC utilised lay interviewer-administered structured interviews to determine mental health diagnoses, one should be mindful that diagnoses are epidemiological research diagnoses rather than clinician diagnoses.


CONCLUSIONS
This study demonstrated the utility of LCA for identifying clinically meaningful subgroups of treatment-seeking behaviour.
Carragher
Natacha
N
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. n.carragher@unsw.edu.au
Adamson
Gary
G
Bunting
Brendan
B
McCann
Siobhan
S
D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data / Q000639:trends; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data