Meta-analysis suggests the need for scaling up treatment for major depressive disorder in some low and lower-middle-income countries.
Major depressive disorder causes persistent feelings of sadness and loss of interest. It affects how you feel, think, and behave and can lead to emotional and physical problems. Symptoms can include irritability, sleep disturbances, anxiety, and concentration issues.
In recent years, national and global initiatives have made increasing efforts to address the tremendous burden of major depressive disorder. Treatment rates remain low despite this fact. The researchers combined analysis from 149 earlier studies and found that treatment rates for major depressive disorder remain low worldwide, particularly for people living in low and lower-middle-income countries.
Alize Ferrari of the University of Queensland, Australia, Modhurima Moitra of the University of Washington, US, and colleagues presented these findings in the open-access journal PLOS Medicine.
The burden of major depressive disorder
Growing efforts to address the burden of major depressive disorder have been made, yet treatment rates remain low. The combination of results from studies on depression treatment from different regions can help identify opportunities for improvement. However, such analyses do not adequately account for variations in the study methods, which consequently makes results from different studies difficult to compare.
To provide further clarity, Ferrari and colleagues conducted an updated analysis of 149 studies on treatment for major depressive disorder conducted in 84 countries between 2000 and 2021. Applying a statistical method known as Bayesian meta-regression analysis, they combined the studies to examine treatment rates around the world.
The findings of this meta-analysis suggested that treatment rates remain low worldwide, and highlights disparities in treatment between countries with different resource levels. Astoundingly, the researchers found that the use of mental health services by people with major depressive disorder is estimated to be 33% in high-income countries and only 8% in low and lower-middle-income countries.
Rates of treatment for major depressive disorder were lower, estimated at 23% in high-income countries and 3% in low and lower-middle-income countries.
Lack of high-quality data for low and lower-middle-income countries
The authors noted a lack of high-quality data on major depressive disorder treatment for low and lower-middle-income countries, mostly in Sub-Saharan Africa and South Asia. This highlights the need for further research to address the gap and improve the accuracy of the treatment rates reported in the study. Future research could also examine how to best improve treatment access in different regions.
Overall, the researchers say, their findings could help inform efforts by governments and policymakers to more effectively address depression treatment worldwide.
Ferrari added, “Treatment coverage for major depressive disorder continues to be low globally, with many individuals failing to receive a level of care consistent with practice guideline recommendations. This highlights the need to reconsider the availability of appropriate care and facilitators of treatment as we respond to the large burden imposed by this disorder.”
