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Antidepressant Use Rising as Psychotherapy Rates Fall
Date:12/6/2010

m two national surveys on depression, one conducted in 1998 and one done in 2007. In that time period, there was a small increase in outpatient treatment rates (from 2.37 per 100 people to 2.88 per 100 people), and only a nominal bump in antidepressant use.

However, the percentage of patients seeking psychotherapy for depression plummeted, from nearly 54 percent to just above 43 percent.

The study authors theorized that a number of factors are driving the trend, not all of which reflect patient preferences. For example, they pointed out that the rise in the rate of prescription drug use may have slowed somewhat as a result of safety concerns, particularly with respect to their usage among younger patients.

At the same time, Olfson and his team noted that today's health insurance coverage often provides payment for cheaper medicinal treatments, while placing strict limits on more expensive psychotherapy treatment.

"I don't see these trends as alarming," said Dr. Michael W. O'Hara, a professor of psychology at the University of Iowa, in Iowa City. "Especially given that it seems to me that there's a lot more visibility to depression and an increasing acceptance to it being treated in general. It's just that the proportion of people being treated with prescription drugs has been going up relative to psychotherapy."

"Now my experience is that many patients say they prefer to just talk to somebody," O'Hara noted. "But certainly it's true that there are many barriers to that, such as the fact that getting psychotherapy requires some effort, you have to go someplace, it may cost you more out-of-pocket, and there may be more stigma involved than just taking drugs."

"It's also the case that one of the things we're seeing as well is that antidepressant medication is now very heavily marketed directly to the consumer," he added. "I would argue that there has been a dramatic increase in TV, radio, print ads advocating that patients take these
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