Department of Psychology, Yale University, New Haven, CT, USA.
Department of Psychiatry, National Taiwan University Hospital & College of Medicine, Taipei, Taiwan.
Psychol Med. 2023 Mar;53(4):1583-1591. doi: 10.1017/S0033291721003160. Epub 2021 Sep 23.
The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries.
Face-to-face interviews with community samples totaling = 49 919 respondents in the World Health Organization (WHO) World Mental Health (WMH) Surveys asked about ADM use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses and asked of all respondents.
3.1% of respondents reported ADM use within the past 12 months. In high-income countries (HICs), depression (49.2%) and anxiety (36.4%) were the most common reasons for use. In low- and middle-income countries (LMICs), depression (38.4%) and sleep problems (31.9%) were the most common reasons for use. Prevalence of use was 2-4 times as high in HICs as LMICs across all examined diagnoses. Newer ADMs were proportionally used more often in HICs than LMICs. Across all conditions, ADMs were reported as effective by 58.8% of users and effective by an additional 28.3% of users, with both proportions higher in LMICs than HICs. Neither ADM class nor reason for use was a significant predictor of perceived effectiveness.
ADMs are in widespread use and for a variety of conditions including but going beyond depression and anxiety. In a general population sample from multiple LMICs and HICs, ADMs were widely perceived to be either very or somewhat effective by the people who use them.
重度抑郁症（MDD）最常见的治疗方法是抗抑郁药物（ADM）。本研究报告了 20 个国家的一般人群调查中 ADM 使用频率、使用原因和普遍使用效果。
在世界卫生组织（WHO）的世界心理健康调查（WMH）中，对社区样本进行面对面访谈，共纳入了 49919 名受访者，询问他们在过去 12 个月内是否使用过 ADM，同时还进行了经过验证的完全结构化诊断访谈。治疗问题与诊断分开进行，并询问所有受访者。
3.1%的受访者报告在过去 12 个月内使用过 ADM。在高收入国家（HICs），抑郁（49.2%）和焦虑（36.4%）是使用的最常见原因。在中低收入国家（LMICs），抑郁（38.4%）和睡眠问题（31.9%）是使用的最常见原因。在所有检查的诊断中，HICs 的使用比例是 LMICs 的 2-4 倍。在 HICs 中，新型 ADM 的使用比例高于 LMICs。在所有情况下，58.8%的使用者认为 ADM 有效，另外 28.3%的使用者认为 ADM 非常有效，这两个比例在 LMICs 都高于 HICs。ADM 类别和使用原因都不是感知有效性的显著预测因素。
ADM 的使用非常广泛，可用于多种疾病，包括但不限于抑郁和焦虑。在来自多个 LMICs 和 HICs 的一般人群样本中，使用 ADM 的人普遍认为其非常或有些有效。
