Overcoming treatment gaps in the management of depression with non-pharmacological adjunctive strategies

Front Psychiatry. 2023 Nov 28:14:1268194. doi: 10.3389/fpsyt.2023.1268194. eCollection 2023.

Abstract

There is considerable evidence that simple, cost-effective, non-pharmaceutical strategies can be readily implemented to improve outcomes in the treatment of depression. It is estimated that 4.4% of the world's population suffers from depression. Despite being a major public health concern and the availability of both pharmacological and non-pharmacological treatments, many depressed people remain undiagnosed and receive no or inappropriate treatment. Several possible underlying factor of treatment gap can be identified in relation to pharmacotherapy and psychotherapy of depression, including side effects, partial remission, treatment-resistant depression and the limited availability of psychotherapy. In addition to developing new therapeutic options, much more could be done to optimise the use of existing therapies, including combining available drug treatments with quick, simple and cost-effective non-pharmacological methods: low-intensity psychological interventions, online self-help tools and lifestyle medicine. In addition to increasing the effectiveness of treatments, prevention is equally important: awareness programs to further reduce the treatment gap, and community dissemination of the life skills that help maintain positive mental health.

Keywords: depression; pharmacological treatment; prevention; psychotherapy; synergism; treatment gap; unmet need.

Publication types

  • Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Open access funding provided by Semmelweis University and by the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement No. 848137. The material presented and views expressed here are the responsibility of the author(s) only. The EU Commission takes no responsibility for any use made of the information set out. The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.