Olfson Mark, Marcus Steven C
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Arch Gen Psychiatry. 2009 Aug;66(8):848-56. doi: 10.1001/archgenpsychiatry.2009.81.
Antidepressants have recently become the most commonly prescribed class of medications in the United States.
To compare sociodemographic and clinical patterns of antidepressant medication treatment in the United States between 1996 and 2005.
Analysis of antidepressant use data from the 1996 (n = 18 993) and 2005 (n = 28 445) Medical Expenditure Panel Surveys.
Households in the United States.
Respondents aged 6 years or older who reported receiving at least 1 antidepressant prescription during that calendar year.
Rate of antidepressant use and adjusted rate ratios (ARRs) of year effect on rate of antidepressant use adjusted for age, sex, race/ethnicity, annual family income, self-perceived mental health, and insurance status.
The rate of antidepressant treatment increased from 5.84% (95% confidence interval [CI], 5.47-6.23) in 1996 to 10.12% (9.58-10.69) in 2005 (ARR, 1.68; 95% CI, 1.55-1.81), or from 13.3 to 27.0 million persons. Significant increases in antidepressant use were evident across all sociodemographic groups examined, except African Americans (ARR, 1.13; 95% CI, 0.89-1.44), who had comparatively low rates of use in both years (1996, 3.61%; 2005, 4.51%). Although antidepressant treatment increased for Hispanics (ARR, 1.75; 95% CI, 1.60-1.90), it remained comparatively low (1996, 3.72%; 2005, 5.21%). Among antidepressant users, the percentage of patients treated for depression did not significantly change (1996, 26.25% vs 2005, 26.85%; ARR, 0.95; 95% CI, 0.83-1.07), although the percentage of patients receiving antipsychotic medications (5.46% vs 8.86%; ARR, 1.77; 95% CI, 1.31-2.38) increased and those undergoing psychotherapy declined (31.50% vs 19.87%; ARR, 0.65; 95% CI, 0.56-0.72).
From 1996 to 2005, there was a marked and broad expansion in antidepressant treatment in the United States, with persisting low rates of treatment among racial/ethnic minorities. During this period, individuals treated with antidepressants became more likely to also receive treatment with antipsychotic medications and less likely to undergo psychotherapy.
抗抑郁药最近已成为美国最常用的处方药类别。
比较1996年至2005年美国抗抑郁药物治疗的社会人口统计学和临床模式。
对1996年（n = 18993）和2005年（n = 28445）医疗支出面板调查中的抗抑郁药使用数据进行分析。
美国的家庭。
年龄在6岁及以上且报告在该日历年至少接受过1次抗抑郁药处方的受访者。
抗抑郁药使用率以及根据年龄、性别、种族/族裔、家庭年收入、自我感知的心理健康状况和保险状况调整后的年份对抗抑郁药使用率影响的调整率比（ARR）。
抗抑郁药治疗率从1996年的5.84%（95%置信区间[CI]，5.47 - 6.23）增至2005年的10.12%（9.58 - 10.69）（ARR，1.68；95% CI，1.55 - 1.81），即从1330万人增至2700万人。在所有接受调查的社会人口统计学群体中，除非洲裔美国人外（ARR，1.13；95% CI，0.89 - 1.44），抗抑郁药使用均显著增加，非洲裔美国人在这两年中的使用率相对较低（1996年为3.61%；2005年为4.51%）。尽管西班牙裔的抗抑郁药治疗有所增加（ARR，1.75；95% CI，1.60 - 1.90），但其使用率仍相对较低（1996年为3.72%；2005年为5.21%）。在抗抑郁药使用者中，因抑郁症接受治疗的患者比例没有显著变化（1996年为26.25%，2005年为26.85%；ARR，0.95；95% CI，0.83 - 1.07），尽管接受抗精神病药物治疗的患者比例有所增加（5.46%对8.86%；ARR，1.77；95% CI，1.31 - 2.38），而接受心理治疗的患者比例有所下降（31.50%对19.87%；ARR，0.65；95% CI，0.56 - 0.72）。
从1996年到2005年，美国抗抑郁药治疗有显著且广泛的扩展，但种族/族裔少数群体的治疗率持续较低。在此期间，接受抗抑郁药治疗的个体更有可能同时接受抗精神病药物治疗，而接受心理治疗的可能性降低。
