Table 1.

Summary of treatment gap data by country.

Treatment gap	Country	Summary of findings
1. Detection rates	International	Estimates ranging from 25 to 70% detection with most estimates between 45 and 65%.
	UK	Estimates ranging from 35 to 64%, averaging approximately 50% detection.
	Germany	Estimates ranging from 21 to 75%, averaging approximately 55% detection.
	Portugal	Uncertain/high percentage detection (single study).
	Sweden	Wide ranging estimates averaging approximately 57% detection.
	Italy	Estimates averaging detection between 30 and 64%.
	Hungary	As few as 7% of true depression cases could be detected in primary care (single study).
2. Delays to detection and treatment	International	Estimates ranging from 1 to 8 years (mode 8 years) overall depressive illness.
	UK	Average 8 years (single study), >2 years (within episode), 43% TRD patients. a
	Germany	Wide variation averaging ~2 years, >3 months (within episode), 66% patients (single study).
	Italy	Average 3.25 years, >6 months (within episode), 64% patients.
3. Treatment rates (pharmacological and psychological)	International	20–52% of diagnosed untreated (~70% untreated in samples including undiagnosed). Only ~25% psychological.
	UK	21–32% of diagnosed untreated (~70% untreated in samples including undiagnosed). ~25% psychological.
	Portugal	45% untreated. Most pharmacological, 38% lifetime psychological therapy (single study).
	Sweden	53% of diagnosed patients not offered treatment (actual treatment rate lower; single study).
	Italy	61–79% of diagnosed untreated (antidepressants). ~37% of diagnosed some psychological (single study).
	Hungary	55–60% diagnosed but untreated with antidepressants.
4. Follow-up rates after treatment	International	1/3 no FU within 3 months, 1/3 some FU, 1/3 adequate FU (≥3 visits within 3 months).
	UK	2/3 FU within 2 months; proportion offered but not attended FU may be slightly higher.
	Portugal	General: Average 2 and 3 primary care visits per year in treated people with MDD (single study).
	Italy	General: 60% of MDD patients had ≥1 primary care visit per month (nonspecific to MDD; single study).
5. Access to secondary care	International	~24–38% of diagnosed patients referred to secondary care (note: referral rather than contact rates).
	UK	Most estimates 5–21% (up to 44% in one unrepresentative sample of people with TRD).
	Germany	~12% of diagnosed MDD patients (single study).
	Portugal	22–28% treated in secondary services within 12 months.
	Italy	~1–10% of people with MDD in psychiatric care, although highly accessible after inpatient discharge.

Note: No data available from individual countries not shown.

Abbreviations: FU, follow-up; MDD, major depressive disorder.

^aAdditional data not reported here (not comparable in scope to most other studies).