Recovery from major depression is an important public health issue because depression deprives people of truly enjoying life. The disorder is quite common and its lifetime prevalence is 3% to 17%. Some symptoms of major depression are feelings of sadness, guilt, helplessness, hopelessness, little or no pleasure or even having lost interest in many facets of life. For many individuals who go through a major depressive episode, major depression can become a recurrent and chronic condition. According to the World Health Organization (WHO), there are approximately 350 million people across the world suffering from this mental health disorder. According to the U.S. National Comorbidity Survey – Replication (NCS-R), the major depression twelve-month prevalence rate is approximately 6.6%. And in the Canadian Community Health Survey – Mental Health (CCHS-MH), it is estimated to be 4.7%.
According to the CCHS-MH, women are at a higher rate than men at 4.9% as opposed to 2.8% for men for past year major depressive episode and in the NCS-R, the lifetime odds ratio for women vs. men is 1.7. The NCS-R showed that for 12-month major depressive episode, the odds ratio for lifetime cases is highest in patients 18 to 29 years old. The CCHS-MH showed that the 12-month prevalence was highest for those 15 years old, which were the youngest patients in each survey. The data from the CCHS-MH suggest the past-year prevalence of people having a major depressive episode has stayed constant in Canada throughout the past decade.
Major depression is the second top cause of disability across the world and the top cause of disability for adolescents from 10 to 19 years of age. Failure to achieve recovery form major depression can result in symptoms that impede a person’s ability to do their schoolwork or perform their job, handle family responsibilities, and get any enjoyment from leisure activities. The truth is that 87.4% of those responding to the NCS-R survey who suffer from 12-month major depression said they had at least a moderate amount of impairment at work, home, in a relationship, or in social role functioning.
Many patients suffering from major depression are left untreated, and among the ones who do get treatment, a significant percentage does not recover their former level of functioning. Using data from the National Survey on Drug Use & Health from the 2005 and 2006 surveys, 37.6% of those participating that had major depression never sought treatment. A closer analysis that looked at the recognition and subsequent diagnosis of depression said that in settings offering primary care, less than half of all valid cases of depression were actually diagnosed. Furthermore, less than half being treated with antidepressants for major depression achieve remission or achieve recovery from major depression.
In a review of 30 studies analyzing randomized controlled medical trials of the use of selective serotonin reuptake inhibitors (SSRIs), along with serotonin-norepinephrine reuptake inhibitors (SNRIs), plus tricyclic antidepressants (TCAs) it was found that recovery from major depression occurred in 38% to 61% of the cases. There was not one antidepressant that consistently showed superior efficacy for each patient. An analysis was done looking at functional and symptomatic remission while receiving acute treatment that showed 38% of patients did achieve symptomatic remission according to the 17-question Hamilton Depression Rating Scale (HDRS-17), achieving a score of < 7. To measure functional recovery from major depression the Sheehan Disability Scale (SDS) was used, which showed that 32% achieved functional remission with a score of < 6, however only 23% of the patients were able to achieve both functional and symptomatic recovery from major depression.
As you can see from this review of 30 studies, recovery from major depression is not easy or guaranteed. Our intensive outpatient program has published eight peer reviewed publications showing the results of our symptom and functional rates of recovery from major depression. Our results show that most patients who complete treatment will achieve significant reductions in depression symptoms and improvements in daily activities in work / school, social and family spheres. If you are looking for an intensive outpatient program for depression with proven results, please give us a call.