Table 5.
(All countries): Factors associated with helpful depression treatment and persistence (pooled across professionals seen), and perceived helpfulness of depression treatment (person level), among people with lifetime DSM-IV MDE with mania/hypomania who obtained depression treatment
| Model 1: Predicting helpful depression treatment pooled across professionals seen |
Model 2: Predicting persistence pooled across depression treatment failure |
Model 3: Predicting perceived helpfulness of depression treatment across patients |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Prevalence | Multivariate | Prevalence | Multivariate | Prevalence | Multivariate | ||||||||||
| Mean/ % |
(SE) | (n) | OR | (95% CI) | Mean/ % |
(SE) | (n) | OR | (95% CI) | Mean/ % |
(SE) | (n) | OR | (95% CI) | |
| Age of first depression treatment | 26.4 | (0.9) | (783) | 1.00 | (0.98-1.03) | 25.7 | (1.0) | (599) | 1.01 | (0.98-1.05) | 27.3 | (0.6) | (280) | 0.98 | (0.93-1.04) |
| χ21 | 0.07 | 0.84 | 0.36 | ||||||||||||
| Gender | |||||||||||||||
| Female | 58.3 | (6.1) | (783) | 1.03 | (0.60-1.74) | 58.2 | (7.1) | (599) | 0.50* | (0.29-0.87) | 58.6 | (3.6) | (280) | 0.81 | (0.38-1.73) |
| Male | 41.7 | (6.1) | (783) | 1.00 | - | 41.8 | (7.1) | (599) | 1.00 | - | 41.4 | (3.6) | (280) | 1.00 | - |
| χ21 | 0.01 | 6.01* | 0.30 | ||||||||||||
| Marital Status | |||||||||||||||
| Never married | 51.6 | (6.1) | (783) | 0.85 | (0.55-1.32) | 52.5 | (6.9) | (599) | 1.27 | (0.64-2.53) | 50.9 | (3.5) | (280) | 1.23 | (0.60-2.50) |
| Previously married | 13.9 | (4.0) | (783) | 0.69 | (0.31-1.51) | 13.7 | (4.4) | (599) | 1.02 | (0.29-3.51) | 12.8 | (2.4) | (280) | 1.23 | (0.25-5.99) |
| Currently married | 34.5 | (6.3) | (783) | 1.00 | - | 33.9 | (7.2) | (599) | 1.00 | - | 36.3 | (3.4) | (280) | 1.00 | - |
| χ22 | 1.05 | 0.56 | 0.40 | ||||||||||||
| Education | |||||||||||||||
| Low | 5.8 | (2.8) | (783) | 1.58 | (0.53-4.69) | 5.3 | (3.2) | (599) | 3.11 | (0.44-22.18) | 5.6 | (1.3) | (280) | 3.12 | (0.53-18.39) |
| Low-average | 18.8 | (3.0) | (783) | 1.42 | (0.59-3.45) | 16.6 | (3.1) | (599) | 0.72 | (0.33-1.60) | 23.5 | (2.8) | (280) | 0.91 | (0.28-2.97) |
| High-average | 41.4 | (6.7) | (783) | 1.26 | (0.59-2.69) | 42.8 | (7.6) | (599) | 0.50 | (0.21-1.18) | 36.5 | (3.6) | (280) | 0.69 | (0.18-2.55) |
| Student | 22.6 | (4.3) | (783) | 0.64 | (0.27-1.51) | 24.9 | (4.9) | (599) | 0.66 | (0.29-1.47) | 21.4 | (2.9) | (280) | 0.27 | (0.07-1.09) |
| High | 11.4 | (2.1) | (783) | 1.00 | - | 10.5 | (2.1) | (599) | 1.00 | - | 13.0 | (1.7) | (280) | 1.00 | - |
| χ24 | 7.51 | 5.19 | 6.92 | ||||||||||||
| Depression treatment delay (years)† | 6.0 | (1.0) | (783) | 1.01 | (0.97-1.05) | 5.7 | (1.2) | (599) | 1.00 | (0.96-1.03) | 6.2 | (0.6) | (280) | 1.03 | (0.97-1.08) |
| χ21 | 0.11 | 0.01 | 0.94 | ||||||||||||
| Started depression treatment >= 2000 (vs. 1990-1999) | 49.0 | (6.3) | (783) | 1.45 | (0.87-2.43) | 45.0 | (7.2) | (599) | 0.37* | (0.18-0.75) | 65.2 | (3.2) | (280) | 1.14 | (0.53-2.49) |
| χ21 | 2.05 | 7.65* | 0.12 | ||||||||||||
| Treatment type‡ | |||||||||||||||
| Mental health specialist psychotherapy | 44.4 | (6.0) | (783) | 0.52* | (0.32-0.85) | 44.1 | (6.9) | (599) | 1.47 | (0.71-3.04) | 45.0 | (3.2) | (280) | 0.47 | (0.22-1.02) |
| Mental health specialist + medication |
75.1 | (4.1) | (783) | 0.53 | (0.26-1.09) | 76.4 | (4.6) | (599) | 3.28* | (1.03-10.39) | 60.5 | (3.2) | (280) | 1.17 | (0.40-3.40) |
| General medical | 71.7 | (6.3) | (783) | 0.60 | (0.32-1.09) | 73.7 | (7.2) | (599) | 2.98* | (1.26-7.06) | 63.5 | (3.1) | (280) | 1.07 | (0.42-2.76) |
| Complementary/alternative medicine |
35.5 | (7.3) | (783) | 0.66 | (0.36-1.18) | 38.3 | (8.3) | (599) | 3.99* | (1.63-9.72) | 21.0 | (3.3) | (280) | 1.23 | (0.38-3.96) |
| Human services | 30.9 | (7.2) | (783) | 1.00 | - | 34.3 | (8.2) | (599) | 1.00 | - | 19.4 | (3.3) | (280) | 1.00 | - |
| χ24 | 7.63 | 17.40* | 5.43 | ||||||||||||
| Exactly 2 or more of the above | 80.1 | (3.2) | (783) | 1.88 | (0.78-4.53) | 81.8 | (3.3) | (599) | 2.17 | (0.64-7.33) | 64.0 | (3.2) | (280) | 4.68* | (1.22-18.00) |
| χ21 | 1.95 | 1.55 | 5.05* | ||||||||||||
| χ25 | 7.79 | 59.53* | 18.02* | ||||||||||||
| Anxiety disorders§ | |||||||||||||||
| Any anxiety disorders | 79.3 | (3.1) | (783) | 0.84 | (0.51-1.39) | 80.6 | (3.5) | (599) | 2.82* | (1.54-5.18) | 68.2 | (3.1) | (280) | 2.33* | (1.10-4.96) |
| No anxiety disorder | 20.7 | (3.1) | (783) | 1.00 | - | 19.4 | (3.5) | (599) | 1.00 | - | 31.8 | (3.1) | (280) | 1.00 | - |
| χ21 | 0.47 | 11.27* | 4.83* | ||||||||||||
| Substance use disorders¶ | |||||||||||||||
| Any substance use disorders | 35.9 | (5.7) | (783) | 0.97 | (0.59-1.61) | 36.0 | (6.5) | (599) | 0.49* | (0.26-0.92) | 34.5 | (3.4) | (280) | 0.50 | (0.23-1.07) |
| No substance use disorder | 64.1 | (5.7) | (783) | 1.00 | - | 64.0 | (6.5) | (599) | 1.00 | - | 65.5 | (3.4) | (280) | 1.00 | - |
| χ21 | 0.01 | 4.91* | 3.23 | ||||||||||||
| Got helpful lifetime mania/hypomania treatment | 31.9 | (4.4) | (783) | 1.93* | (1.07-3.48) | 27.1 | (4.8) | (599) | 10.41* | (3.67-29.55) | 33.8 | (2.6) | (280) | 14.47* | (4.20-49.85) |
| Got unhelpful lifetime mania/hypomania treatment | 23.7 | (5.3) | (783) | 0.70 | (0.30-1.63) | 26.8 | (6.4) | (599) | 0.76 | (0.41-1.40) | 18.7 | (2.5) | (280) | 0.58 | (0.24-1.41) |
| Had lifetime mania/hypomania but never got mania/hypomania treatment | 44.4 | (6.1) | (783) | 1.00 | - | 46.1 | (6.9) | (599) | 1.00 | - | 47.4 | (3.3) | (280) | 1.00 | - |
| χ22 | 7.61* | 20.80* | 22.58* | ||||||||||||
| χ24 | 13.33* | 27.78* | 25.34* | ||||||||||||
| Have lifetime mania | 37.0 | (5.2) | (783) | 1.05 | (0.70-1.58) | 37.0 | (5.9) | (599) | 1.16 | (0.57-2.35) | 32.4 | (3.1) | (280) | 2.06 | (0.95-4.45) |
| Have lifetime hypomania | 63.0 | (5.2) | (783) | 1.00 | - | 63.0 | (5.9) | (599) | 1.00 | - | 67.6 | (3.1) | (280) | 1.00 | - |
| χ21 | 0.06 | 0.16 | 3.34 | ||||||||||||
| Childhood adversities | |||||||||||||||
| Family dysfunction†† | 36.5 | (6.8) | (783) | 0.85 | (0.44-1.62) | 36.9 | (7.8) | (599) | 1.98 | (0.93-4.23) | 35.0 | (2.8) | (280) | 1.37 | (0.61-3.10) |
| Other‡‡ | 11.9 | (2.0) | (783) | 1.16 | (0.62-2.15) | 10.4 | (1.8) | (599) | 0.82 | (0.34-2.00) | 17.9 | (2.0) | (280) | 0.76 | (0.34-1.73) |
| χ22 | 0.29 | 3.26 | 0.82 | ||||||||||||
| Global χ222 | 42.85* | 279.61* | 118.22* | ||||||||||||
Abbreviations. MDE, major depressive episode; SE, standard error; OR, odds ratio; CI, confidence interval.
Significant at .05 level, two-sided design-based test.
Treatment delay (years) = Age at first depression treatment – Age at onset.
Treatment providers: mental health specialists (psychiatrist, psychiatric nurse, psychologist, psychiatric social worker, mental health counselor), primary care providers, human services providers (social worker or counselor in a social services agency, spiritual advisor), and complementary/alternative medicine (other type of healer or self-help group).
Anxiety disorders include generalized anxiety disorder, panic disorder, agoraphobia with or without panic disorder, post-traumatic stress disorder, specific phobia and social phobia.
Substance use disorders include alcohol and/or drug abuse, alcohol or drug dependence but not abuse.
Family dysfunction includes physical abuse, sexual abuse, neglect, parent mental disorder, parent substance disorder, parent criminal behavior and family violence.
Other includes parent died, parent divorced, other parent loss, physical illness and economic adversity.