Studies: Mental illness over- and undertreated

Patients with mental illness often aren't getting treatments that are "just right." In fact, recent studies show that too many patients are either undertreated or overtreated.

Only about half of people who meet the diagnostic criteria for major depression during a given year were treated, and only one-fourth received the sort of care recommended by the American Psychiatric Association, one study finds. "Few Americans with depression actually get any kind of care, and even fewer get care consistent with the standards of care," says Hector Gonzalez, lead author on the Archives of General Psychiatry study.

Meanwhile, psychiatrists are increasingly prescribing more than one drug during a single office visit, another study shows. Johns Hopkins and Columbia University researchers analyzed data from 13,000 office visits and found that the percentage during which two or more meds were prescribed grew to 60 percent in 2006, up from 43 percent in 1996. And the number of visits that yielded three or more scrips grew to 33 percent, up from 17 percent. This despite the fact that there's not enough evidence supporting combinations of different drugs, researchers say, but that there are worries about the potential for long-term side effects.

The reasons behind these findings are varied: Barriers to treatment could include lack of adequate insurance coverage and/or worries about any stigma associated with a diagnosis of mental illness. As for the multiple scrips, doctors may have grown comfortable enough with the variety of psychotropic meds to combine them. Off-label use may be a factor, too.

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