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Comparison of treated and untreated major depressive disorder in a nationwide sample of Korean adults

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Authors
Kim, K.; Park, S.; Choi, J. W.; Park, J. I.; Cho, M. J.; Hong, J. P.
Issue Date
2010-08
Publisher
ELSEVIER SCIENCE BV
Citation
EUROPEAN NEUROPSYCHOPHARMACOLOGY; Vol.20 ; S322-S323
Abstract
Individuals with MDD manifest various symptoms ranging from
depressive mood to suicide idea [1]. Some of symptoms can be
more distressing and make them seek treatment, while other symptoms
can be ignored because they are less distressing, thought to
be self-limited, or thought to be untreatable. In addition, MDD
is often comorbid with other psychiatric disorders [2], which
could aggravate depression and vice versa and affect mental
health service utilization of depressed patients. The objective of
this study is to examine the correlates of treatment-seeking in
respondents with MDD, including psychopathology and comorbid
psychiatric conditions in addition to the relatively well-known
socio-demographic and clinical characteristics in a nationwide
community sample in Korea.
Among the total of 6,510 subjects aged 18−64 years participated
in the Korean Epidemiologic Catchment Area study
(KECA-R), 362 subjects with lifetime diagnosis of MDD were selected
for the analysis in the present study. Diagnostic assessments
were based on the Korean version of Composite International
Diagnostic Interview 2.1 [3] administered by lay interviewers.
Among 362 respondents with lifetime diagnosis of MDD,
32.3% (171/362) have ever treated for mental health problems.
Among 161 subjects diagnosed as having 12-months MDD, 17.4%
(28/161) have treated for mental health problems in the preceding
12 months. Treated individuals with MDD were more
likely to be older and have a medical illness than untreated
participants. Sex, area of residence, marital status, educational
level, and type of occupation were not associated with treatment.
Compared to the untreated cases, treated individuals with MDD
were more likely to have chronic episode (OR 1.86, 95% CIs 1.13–
3.06), more depression symptoms (OR 1.69, 95% CIs 1.05–2.71),
insomnia (OR 2.43, 95% CIs 1.22–4.85), and suicidal ideation
(OR 2.03, 95% CIs 1.21–3.38), and less likely to have guilty feeling (OR 0.55, 95% CIs 0.32–0.97). In addition, treated individuals
with MDD were more likely to have comorbid anxiety
disorder, especially obsessive-compulsive disorder, post-traumatic
stress disorder, and generalized anxiety disorder than untreated
participants. No comorbid psychiatric disorder was significantly
associated with underuse of psychiatric treatment. In case of
untreated individuals with MDD, the most common reason for
not seeking treatment was that they wanted to handle the problem
on their own (71.7%). The second most common reason was that
they did not think they had a mental illness (65.8%). The following
common reasons were that they thought that the problem would
get better by itself (54.0%), the problem did get better by itself
(47.1%), and the problem did not bother respondent very much
(35.8%).
Treatment-seeking of persons with MDD is affected by manifesting
psychopathology and comorbid medical and psychiatric
disorder as well as socio-demographic factors and characteristic
of depressive episode. While it is reassuring that chronic and
severe patients who should receive a treatment report higher
rates of treatment-seeking, persons with MDD still underuse the
mental health service, and effort should be directed to reduce
stigma associated with mental illness and to get depressed patients
involved in treatment earlier.
ISSN
0924-977X
Language
English
URI
http://hdl.handle.net/10371/78453
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Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Psychiatry (정신과학전공)Journal Papers (저널논문_정신과학전공)
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