title: Antidepressant use in the absence of common mental disorders in the general population.
abstract: OBJECTIVE
  To examine the prevalence of antidepressant use in the absence of lifetime mental disorders and to examine sociodemographic correlates, indicators of need (hospitalization, suicidal behavior, perceived need, subthreshold disorders, disability, traumatic events), and antidepressant characteristics of such use.
  
  
  METHODS
  Data came from the Collaborative Psychiatric Epidemiologic Surveys (N = 20,013), a nationally representative cross-sectional sample of community-dwelling adults in the United States. Sociodemographic correlates and indicators of need were examined as predictors of past-year use of antidepressants in the absence of a lifetime DSM-IV diagnosis as assessed by the World Mental Health Composite Diagnostic Interview. The surveys were conducted between 2001 and 2003.
  
  
  RESULTS
  Among individuals who took an antidepressant in the past year (n = 1,441), 396 (26.3%) did not meet criteria for any lifetime diagnosis assessed. Respondents taking antidepressants in the absence of a lifetime diagnosis tended to be older, white, and female. All indicators of need except past-year suicidal behavior were significant predictors (adjusted odds ratios ranging from 2.12 to 14.22, P < .001), with 89% of individuals taking antidepressants in the absence of a lifetime diagnosis endorsing at least 1 indicator of need. Individuals taking antidepressants in the absence of a DSM-IV disorder were more likely to have been prescribed these medications by family physicians or other doctors compared to psychiatrists.
  
  
  CONCLUSIONS
  These results suggest that antidepressant use among individuals without psychiatric diagnoses is common in the United States and is typically motivated by other indicators of need. These findings have important implications for the delivery of medical and psychiatric care and psychiatric nosology.
authors.affiliation: Department of Clinical Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jina
authors.initials: J
authors.lastname: Pagura
authors.forename: Laurence Y
authors.initials: LY
authors.lastname: Katz
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Druss
authors.forename: Brian
authors.initials: B
authors.lastname: Cox
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents