Health Care Utilization and Appropriateness of Treatments for Major Depressive Episodes in France.
Understanding where people with depression turn for help and the treatments they receive is essential to increasing the proportion of appropriate treatments. The objective of this article is to better understand healthcare utilization and the appropriateness of treatment for individuals with a major depressive episode (MDE) based on the different healthcare professionals they consult, using data from a 2005 national epidemiological survey of the general population (2005 Health Barometer, n = 16,883) by the National Institute for Prevention and Health Education. 7.8% of individuals had experienced a MDE within the past year. Six out of ten sought care; one-third of them received appropriate treatment (21% of those with MDEs). Among those who sought care, two-thirds consulted a mental health professional—representing one-third of EDM cases—while the remaining proportion (21.4% of EDM cases) used psychotropic medications without reporting that they had consulted a professional for a mental health issue. Almost all consultations were with a “qualified professional (PRC)” (34.6% of EDMs). Among PRCs, the most common type of consultation was with general practitioners (GPs) (61%, or 21.1% of EDMs), with 38.4% (13.3% of EDMs) consulting psychiatrists (PCT) and 27.8% (9.6% of EDMs) consulting non-psychiatrist mental health professionals (PNP). The lowest rates of appropriate treatment are observed among EDMs who report not having sought help from a professional. Among those who sought help from a PRC, the lowest rate of appropriate treatment is observed for seeking help from a GP: 37.2%. The highest proportions are observed for seeking care from a mental health professional (65.1%) and, in particular, for seeking care from both a mental health professional and a general practitioner (79.7%). The rates of use for different types of treatment (antidepressants [ATD] and psychotherapy [PT]) vary greatly. Among EDMs, 33.4% used ADs (of whom 58.4% also used anxiolytics [AXLs]). 26.9% used AXL, 7.5% without taking ATD; 10.8% of EDM patients used PT, and 8.1% used both PT and ATD. [author’s abstract]
Author(s): Briffault X, Morvan Y, Rouillon F, Dardennes R, Lamboy B
Publishing year: 2010
Pages: D48-D58
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