Photo by Damir Samatkulov on Unsplash
Photo by Damir Samatkulov on Unsplash

The majority of people globally with major depressive disorder aren't getting treatment

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Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Meta-analysis: This type of study involves using statistics to combine the data from multiple previous studies to give an overall result. The reliability of a meta-analysis depends on both the quality and similarity of the individual studies being grouped together.

People: This is a study based on research using people.

One in three people with major depressive disorder (MDD) in high income countries are receiving treatment compared to less than one in 12 in low to middle income countries, according to Aussie and international researchers. The team compiled 149 studies from around the world to estimate the rate of treatment for major depressive disorders globally. They say the rate of those with MDD receiving treatment of a sufficient standard is lower, 23 per cent for high income countries and just three per cent for low and middle income countries. The researchers say this shows the world has a long way to go to develop adequate support systems to treat depression in each country.

Journal/conference: PLOS Medicine

Link to research (DOI): 10.1371/journal.pmed.1003901

Organisation/s: The University of Queensland

Funder: This research was supported by the Institute for Health Metrics and Evaluation which receives funding from the Bill & Melinda Gates Foundation. AJF is supported by a National Health and Medical Research Council Early Career Fellowship Grant (APP1121516). AJF, DS and HW are employed by the Queensland Centre for Mental Health Research which receives core funding from the Queensland Department of Health, (Queensland Australia). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Media release

From: PLOS

Peer-reviewed                                 Meta-analysis                                  People

Study highlights worldwide disparities in treatment rates for major depressive disorder

Meta-analysis suggests need for scaling up treatment for this severe depression in some low and lower-middle income countries

A combined analysis of results from 149 earlier studies finds that treatment rates for major depressive disorder remain low worldwide, particularly for people living in low and lower-middle income countries. Alize Ferrari of the University of Queensland, Australia, Modhurima Moitra of the University of Washington, U.S., and colleagues present these findings in the open-access journal PLOS Medicine.

In recent years, national and global initiatives have made increasing efforts to address the tremendous burden posed by major depressive disorder. However, treatment rates remain low. Analyses that combine results from studies on depression treatment from different regions can help identify opportunities for improvement. However, many such analyses do not adequately account for variations in study methods that make results from different studies difficult to compare.

To provide further clarity, Ferrari and colleagues conducted an updated analysis of 149 studies on treatment for major depressive disorder conducted in 84 countries between 2000 and 2021. Applying a statistical method known as Bayesian meta-regression analysis, they combined the studies to examine treatment rates around the world.

The findings of this meta-analysis suggest that treatment rates remain low worldwide, and it highlights disparities in treatment between countries with different resource levels. In particular, use of mental health services by people with major depressive disorder is estimated to be 33 percent in high-income countries and just eight percent in low and lower-middle income countries.

Rates of treatment considered to be minimally sufficient for treating major depressive disorder are lower, estimated at 23 percent for high-income countries and 3 percent in low and lower-middle income countries.

The authors note a lack of high-quality data on depression treatment for low and lower-middle income countries, mostly in Sub-Saharan Africa and South Asia; further research could attempt to address that gap and thereby improve the accuracy of the treatment rates reported in this study. Future research could also examine how to best improve treatment access in different regions.

Overall, the researchers say, their findings could help inform efforts by governments and policymakers to more effectively address depression treatment worldwide.

Ferrari adds, “Treatment coverage for major depressive disorder continues to be low globally, with many individuals failing to receive a level of care consistent with practice guideline recommendations.  This highlights the need to reconsider the availability of appropriate care and facilitators of treatment as we respond to the large burden imposed by this disorder.”

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