Prise en charge des personnes souffrant de troubles dépressifs–Données d’enquête en population générale: Use of health services and treatments for major depressive episode in France

Abstract

The depressive disorders are among the most frequent disorders in the general population. Various validated treatments exist but, according to international psychiatric epidemiologic surveys, only a minority of currently depressed people seek and receive treatment. To date, in France, few national studies have investigated these problems.By using the data of the national French survey: "Santé mentale en population générale (SMPG)": 1) to estimate the prevalence of use of care services by depressed people in the general population, 2) to evaluate the proportion of depressive subjects who have received drug and/or psychological treatments, 3) to identify the demographic and clinical factors and representations associated with use.SMPG was a transversal survey carried out by the WHO national collaborative center (CCOMS) and the Direction of the statistics of the ministry for Health (DREES). A representative sample of 36 105 non-institutionalised French individuals aged 18 or over was interviewed. Three main questionnaires was used: the Mini International Neuropsychiatric Interview (MINI) questionnaire was used to assess several mental disorders according to the ICD-10 classification, a questionnaire on the representations of the mental disease and the treatments, and a questionnaire on use of care services and treatments received.- 71.9% of depressed people sought or received a treatment and 47.1% stated claimed to be treated for depression. About 20% of people classified as having a recurrent or chronic depressive disorder have never used health care services for mental health. Only 53.4% of subjects having a mild or moderate Major Depressive Episode (MDE) already received a treatment: 42.1% had taken psychotropic drugs only, 3.2% had psychotherapy only, 8.1% had both, and 25.6% had taken antidepressants among the subjects treated by psychotropic drugs; 24% of subjects classified as having a recurrent or chronic depressive disorder have never received a treatment and about 3/4 of them have never received a minimal adequate treatment. Use of services by depressed people was associated with sociodemographic factors, the severity of the disorder and several representations.- The SMPG survey confirms the international finding concerning the treatment of depressed people. Several problems were pointed out: an important part of depressed people had never taken any treatment, less than half claimed they were stated to be treated for depression, a minority received a psychotherapy, and very few had a minimal adequate treatment. In France, more psychiatric epidemiologic surveys are needed to confirm and specify these findings.