Antidepressant Prescribing Patterns At Initial Visits for Patients With Mild Depression: A Retrospective Study

The efficacy of antidepressants in mild depression remains debated. Despite guidelines recommending psychosocial interventions first, antidepressants are often initiated in real-world clinical practice. This study aimed to investigate the prescribing patterns of antidepressants at initial psychiatric consultations for patients with mild depression and to identify symptom-related factors influencing these prescribing decisions.A retrospective chart review was conducted on 1,508 outpatients diagnosed with depression at Kyorin University Hospital between 2020 and 2024. Among them, 171 patients met the criteria for mild depression, defined as a total score of 6-10 on the Quick Inventory of Depressive Symptomatology-Self Report. Independent t-tests and logistic regression analyses were performed to compare demographic and symptom-level characteristics between those who were prescribed antidepressants and those who were not.Of the 171 eligible patients, 28.1% were prescribed antidepressants at their first visit. No significant between-group differences were observed in demographics or overall symptom severity. The Quick Inventory of Depressive Symptomatology-Self Report item "increased weight" showed lower scores in the antidepressant group (0.1±0.4 vs 0.3±0.7, p=0.03), but this was not statistically significant after Benjamini-Hochberg false discovery rate correction and was also not statistically significant in logistic regression. Among participants prescribed monotherapy, no significant differences were found across antidepressant categories.Antidepressants were prescribed at the initial consultation in approximately 30% of patients with mild depression. No symptom item showed a clear, robust association with prescribing, suggesting that factors other than specific symptom profiles may play a more decisive role in real-world treatment selection.