Photo Credit: SewcreamStudio

The following is a summary of “Service coverage for major depressive disorder: estimated rates of minimally adequate treatment for 204 countries and territories in 2021,” published in the December 2024 issue of Psychiatry by Santomauro et al. 

Global access to effective treatment for major depressive disorder (MDD) is limited and difficult to track over time and across regions. 

Researchers conducted a retrospective study to analyze global data on minimally adequate treatment (MAT) for MDD, aiming to provide a metric for monitoring national responses to its growing public health burden. 

They defined MAT as pharmacotherapy (1 month of medication, plus 4 visits to a medical doctor) or psychotherapy (8 visits with any professional). They identified mental health surveys on MDD and health service use, extracting estimates for MAT, antidepressant use, and mental health service use. Estimates were adjusted using a network meta-analysis, and MAT coverage was analyzed via Bayesian meta-regression with DisMod-MR 2.1. The final MAT estimates were standardized by age and sex against the global distribution of people with MDD. 

The results showed that globally, 9.1% (7.2–11.6) of people with MDD received MAT in 2021, with 10.2% (8.2–13.1) of females and 7.2% (5.7–9.3) of males. MAT coverage was highest in high-income locations at 27.0% (21.7–34.4), with Australasia at 29.2% (21.4–40.8). Coverage was lowest in sub-Saharan Africa at 2.0% (1.5–2.6), with western sub-Saharan Africa at 1.8% (1.4–2.5). About 7 countries had coverage above 30%: Australia, Belgium, Canada, Germany, the Netherlands, South Korea, and Sweden, while 90 countries had coverage below 5%. 

Investigators concluded that most individuals with MDD globally did not receive MAT and stressed the need for improved services and urgent action, especially in low- and middle-income countries. 

Source: thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00317-1/fulltext