Antidepressant use in low- middle- and high-income countries: a World Mental Health Surveys report. Issue 4 (23rd March 2023)

• Record Type: Journal Article
• Authors: Kazdin, Alan E.; Wu, Chi-Shin; Hwang, Irving; Puac-Polanco, Victor; Sampson, Nancy A.; Al-Hamzawi, Ali; Alonso, Jordi; Andrade, Laura Helena; Benjet, Corina; Caldas-de-Almeida, José-Miguel; de Girolamo, Giovanni; de Jonge, Peter; Florescu, Silvia; Gureje, Oye; Haro, Josep M.; Harris, Meredith G.; Karam, Elie G.; Karam, Georges; Kovess-Masfety, Viviane; Lee, Sing; McGrath, John J.; Navarro-Mateu, Fernando; Nishi, Daisuke; Oladeji, Bibilola D.; Posada-Villa, José; Stein, Dan J.; Üstün, T. Bedirhan; Vigo, Daniel V.; Zarkov, Zahari; Zaslavsky, Alan M.; Kessler, Ronald C.;
• Is Part Of: Psychological medicine. Volume 53:Issue 4(2023)
• Page Start: 1583
• Page End: 1591
• Publication Date: 2023-03-23
• Subjects: Antidepressant medications -- perceived effectiveness -- reasons for use; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291721003160
• Languages: English
• ISSNs: 0033-2917

Abstract

Abstract: Background: The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries. Methods: Face-to-face interviews with community samples totaling n = 49 919 respondents in the World Health Organization (WHO) World Mental Health (WMH) Surveys asked about ADM use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses and asked of all respondents. Results: 3.1% of respondents reported ADM use within the past 12 months. In high-income countries (HICs), depression (49.2%) and anxiety (36.4%) were the most common reasons for use. In low- and middle-income countries (LMICs), depression (38.4%) and sleep problems (31.9%) were the most common reasons for use. Prevalence of use was 2–4 times as high in HICs as LMICs across all examined diagnoses. Newer ADMs were proportionally used more often in HICs than LMICs. Across all conditions, ADMs were reported as very effective by 58.8% of users and somewhat effective by an additional 28.3% of users, with both proportions higher in LMICs than HICs. Neither ADM class nor reason for use was a significant predictor of perceived effectiveness. Conclusion: ADMs are in widespread use and for a variety of conditions including but going beyond depression and anxiety. In a general population sample from multiple LMICs and HICs, ADMs were widely perceived to be either very or somewhat effective by the people who use them.