Journal article
Trends in the rate of depressive illness and use of antidepressant pharmacotherapy by ethnicity/race: an assessment of office-based visits in the United States, 1992–1997
Clinical therapeutics, Vol.22(12), pp.1575-1589
2000
Handle:
https://hdl.handle.net/2376/116467
PMID: 11192148
Abstract
Objective:
This study was undertaken to determine ethnicity/race-specific (white, black, and Hispanic) population-adjusted rates of US office-based physician visits in which a diagnosis of a depressive disorder was recorded or in which a diagnosis of a depressive disorder was recorded and antidepressant pharmacotherapy was prescribed.
Methods:
Data from the National Ambulatory Medical Care Survey for 1992 through 1997 were partitioned into three 2-year periods: 1992–1993, 1994–1995, and 1996–1997. For each 2-year period, data from office-based physician visits for patients aged 20 to 79 years were extracted to assess, by ethnicity/race, (1) the number of visits in which a diagnosis of a depressive illness was recorded (
International Classification of Diseases, Ninth Revision, Clinical Modification codes 296.2–296.36, 300.4, or 311) and (2) the number of visits in which a diagnosis of a depressive illness was recorded and antidepressant pharmacotherapy was prescribed. We calculated ethnicity/race-specific rates (per 100 US population aged 20 to 79 years) of office-based visits in which a diagnosis of a depressive disorder was recorded and in which a diagnosis of a depressive disorder was recorded and antidepressant pharmacotherapy was prescribed. The specialty of the reporting physician and the proportion of patients receiving a selective serotonin reuptake inhibitor (SSRI) were also discerned.
Results:
From 1992–1993 to 1996–1997, the rate of office-based visits (per 100 US population aged 20 to 79 years) in which a diagnosis of a depressive disorder was recorded increased 3.7% for whites (from 10.9 to 11.3;
P = 0.001), 31.0% for blacks (from 4.2 to 5.5;
P = 0.001), and 72.9% for Hispanics (from 4.8 to 8.3;
P = 0.001). The rate of office-based visits in which a diagnosis of a depressive disorder was recorded and antidepressant pharmacotherapy was prescribed increased 18.5% for whites (from 6.5 to 7.7 per 100;
P = 0.001), 38.5% for blacks (from 2.6 to 3.6 per 100;
P = 0.001), and 106.7% for Hispanics (from 3.0 to 6.2 per 100;
P = 0.001). Between 1992–1993 and 1996–1997, use of an SSRI increased among whites and blacks (from 50.0% to 65.8% and from 40.5% to 58.2%, respectively), but declined among Hispanics (from 51.4% to 48.6%; all comparisons
P = 0.001).
Conclusion:
By 1996–1997, the population-adjusted rates for Hispanics were within a quartile of those observed for whites, whereas the rates for blacks remained at less than half those observed in whites. The observed divergence in population-adjusted rates by ethnicity/race may reflect the nature of the patient-physician relationship, sensitivity and specificity of diagnostic techniques and instruments, and the wider social context in which an office-based visit occurs, including access to and type of health insurance and coverage for mental health services.
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Details
- Title
- Trends in the rate of depressive illness and use of antidepressant pharmacotherapy by ethnicity/race: an assessment of office-based visits in the United States, 1992–1997
- Creators
- Tracy L Skaer - Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, Pullman, U.S.ADavid A Sclar - Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, Pullman, U.S.ALinda M Robison - Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, Pullman, U.S.ARichard S Galin - Pharmacoeconomics and Pharmacoepidemiology Research Unit, College of Pharmacy, Washington State University, Pullman, U.S.A
- Publication Details
- Clinical therapeutics, Vol.22(12), pp.1575-1589
- Academic Unit
- Pharmacotherapy, Department of
- Publisher
- EM Inc USA
- Identifiers
- 99900548307701842
- Language
- English
- Resource Type
- Journal article