• Mark Olfson, Shang-Min Liu, Bridget F Grant, and Carlos Blanco.
• Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. mo49@columbia.edu
• Med Care. 2012 Mar 1; 50 (3): 227-32.

BackgroundAlthough treatment of depression has increased in recent years, long delays commonly separate disorder onset from first treatment contact.ObjectivesThis study evaluates the effects of psychiatric comorbidities and sociodemographic characteristics on lifetime treatment seeking and speed to first treatment contact for major depressive disorder (MDD).MeasuresA cross-sectional epidemiological survey including retrospective structured assessments of DSM-IV MDD and other psychiatric disorders, respondent age at disorder onset, and age at first treatment contact.SubjectsA nationally representative sample of 5958 adults aged at least 18 years residing in households and group quarters who met lifetime criteria for MDD.Data AnalysisThe percentage of respondents with lifetime MDD who reported ever seeking treatment is reported overall and stratified by sociodemographic characteristics. Unadjusted and adjusted hazard ratios (AHRs) are presented on time to first depression treatment seeking by sociodemographic characteristics and comorbid psychiatric disorders.ResultsA majority (61.3%) of respondents with MDD reported having sought treatment for depression at some point in their lives. Time to first depression treatment contact was significantly related to the occurrence of comorbid panic disorder [AHR=2.01, 95% confidence interval (CI), 1.69-2.39], generalized anxiety disorder (AHR=1.55; 95% CI, 1.33-1.81), drug dependence (AHR=1.54; 95% CI, 1.06-2.26), dysthymic disorder (AHR=1.54; 95% CI, 1.35-1.76), and posttraumatic stress disorder (AHR=1.34; 95% CI, 1.13-1.59) and inversely related to male sex (AHR=0.74; 95% CI, 0.66-0.82) and black race/ethnicity (AHR=0.69, 95% CI, 0.59-0.81).ConclusionsComorbid psychiatric disorders, especially panic, generalized anxiety, substance use, and dysthymic disorders, appear to play an important role in accelerating treatment seeking for MDD. Outreach efforts should include a focus on depressed individuals without complicating psychiatric comorbidities.

43 keywords...

hide…