Estimating the global treatment rates for depression: A systematic review and meta-analysis

Tesfa Mekonen; Gary C K Chan; Jason P Connor; Leanne Hides; Janni Leung

doi:10.1016/j.jad.2021.09.038

Estimating the global treatment rates for depression: A systematic review and meta-analysis

J Affect Disord. 2021 Dec 1:295:1234-1242. doi: 10.1016/j.jad.2021.09.038. Epub 2021 Sep 17.

Authors

Tesfa Mekonen¹, Gary C K Chan², Jason P Connor³, Leanne Hides⁴, Janni Leung⁴

Affiliations

¹ School of Psychology, The University of Queensland, Australia; Psychiatry Department, Bahir Dar University, Ethiopia; National Centre for Youth Substance Use Research, The University of Queensland, Australia. Electronic address: t.yimer@uq.net.au.
² National Centre for Youth Substance Use Research, The University of Queensland, Australia.
³ National Centre for Youth Substance Use Research, The University of Queensland, Australia; Discipline of Psychiatry, The University of Queensland, Australia.
⁴ School of Psychology, The University of Queensland, Australia; National Centre for Youth Substance Use Research, The University of Queensland, Australia.

PMID: 34665135
DOI: 10.1016/j.jad.2021.09.038

Abstract

Background: Depression is considered a global crisis due to its high prevalence and associated disabilities. The burden posed by depression could be reduced by increasing access to timely treatment. Limited information is available on treatment rates of depression, particularly in low- and middle-income countries. This study aimed to estimate the treatment rates for depression in the general adult population by World Bank income classification.

Methods: We searched PubMed, EMBASE, PsycINFO, and CINAHL, supplemented with hand-search of reference lists to identify community-based studies. The overall treatment rate for depression was estimated from studies that reported any treatment (behavioral or pharmacological treatments) in healthcare or informal non-healthcare settings. Data were pooled using a random-effects meta-analysis model. Subgroup analyses by income classification were completed. Meta-regression was conducted by study characteristics. The protocol was pre-registered at PROSPERO (CRD42020161683).

Results: We included 65 studies comprising 1.1 million participants from 79 countries and territories. The global 12-month/lifetime pooled treatment rate was 34.8% (95% confidence interval: 29.9, 39.9%). The treatment rates were 48.3% (43.0, 53.6%) in high-income countries, 21.4% (15.1, 27.7%) in middle-income countries, and 16.8% (11.3, 23.0%) in low-income countries. Among the treated samples, 12-month minimally adequate treatment was estimated to be 40%.

Limitation: We reported a substantial level of between-study heterogeneity, which was partially explained by study characteristics in the meta-regression.

Conclusion: Globally, approximately one-third of people with depression receive treatment. Three in five treated people with depression did not receive minimally adequate treatment. Depression treatment rates are considerably lower in low-and middle-income countries.

Keywords: Depression; Health service utilization; Help-seeking; Mental health service; Treatment gap.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adult
Depression* / epidemiology
Depression* / therapy
Humans
Income*
Prevalence