Clinician-identified depression in community settings: concordance with structured-interview diagnoses

Area of Science:

• Psychiatry
• Public Health
• Epidemiology

Background:

• Limited understanding of depression overdiagnosis in community settings.
• Focus on prevalence and correlates of misdiagnosed depression.
• Investigating clinician-identified depression against diagnostic criteria.

Purpose of the Study:

• To determine the proportion of individuals with clinician-identified depression who meet DSM-IV major depressive episode (MDE) criteria.
• To examine characteristics associated with meeting or not meeting MDE criteria.
• To compare mental health profiles and service use between groups.

Main Methods:

• Analysis of 5,639 participants with clinician-identified depression from the 2009-2010 National Survey of Drug Use and Health.
• 12-month MDE criteria ascertained via structured interview.
• Comparison of mental health and service use between MDE and non-MDE groups.

Main Results:

• Only 38.4% of participants met 12-month MDE criteria.
• Older adults (≥65) were less likely (14.3%) to meet criteria; higher education and poorer health were associated with meeting criteria.
• Non-MDE group reported less distress, impairment, and service use, though both groups used psychiatric medications.

Conclusions:

• Depression overdiagnosis and overtreatment are prevalent in US community settings.
• Need for improved diagnostic accuracy and targeted treatment for depression.
• Potential for optimizing mental health service delivery and resource allocation.