Treatment Use and Preference in a Diverse Sample of Women With Mood Disorders

Objectives: To examine differences in treatment use and preference among women with mood disorders based on race, ethnicity, and type of health insurance.

Methods: Women (N = 2,877) with depression, anxiety, and bipolar disorders were surveyed in primary care and specialty clinics affiliated with the National Network of Depression Centers from January 2018 to December 2020. Logistic regression was employed to examine the probabilities of Black, White, and Hispanic women, who varied on public (government-funded) vs private insurance, using and preferring medication, psychotherapy, or complementary treatments.

Results: Black women had lower odds of receiving medications for treatment of all mood disorders, while White women had higher odds. For example, in treatment of depression, the odds ratio (OR) for Black women was 0.435 (P=.011), while the OR for White women was 2.048 (P=.009). Hispanic women had higher odds of using complementary treatments than other women. For example, in treatment of anxiety, their OR was 2.346 (P=.008). Across mood disorders, government-funded (Medicaid/Medicare) coverage was associated with greater use of psychotherapy and complementary treatments (ORs ranging from 1.529 to 5.011) as well as greater medication use for bipolar disorder (OR=5.805, P=.027). Psychotherapy was preferred by the majority of all women (55.5%), although preferences for other treatments differed between racial/ethnic groups.

Conclusions: Research is needed regarding the degree to which clinicians are offering varied treatments to diverse women with mood disorders and how clinicians consider women's preferences. Results highlight the necessity for treatment that integrates culturally based values and preferences, along with policies that ensure treatment access for women who are privately insured.