Health Service Use Among Persons With Self-Reported Depression: A Longitudinal Analysis of 7,164 Women

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Objective

Depression is a common mental disorder and a leading contributor to the global burden of disease. In Australia, depression is reportedly the leading cause of morbidity for young women. In addition to conventional treatments, there is also some evidence that there is common use of complementary and alternative medicine (CAM) among people with depressive symptoms. However, there has been little research focus upon broad health care and practitioner use (including consumption of both conventional and CAM practitioners as well as self-prescribed care) among young adults with depression. This article aims specifically to address this knowledge gap by providing the first longitudinal analysis of the use of health service among women with self-reported depression.

Methods

Data from a longitudinal cohort study (Australian Longitudinal Study on Women's Health) conducted over a 3-year period on 7,164 young Australian women were analyzed. Information on health status, health service use, and self-prescribed treatments was obtained from two questionnaires mailed to study participants in 2003 and 2006.

Results

The study identified that only a small proportion of the women had sought professional assistance for their self-reported depression. It also shows that many women who reported depression used CAM alongside or as a complement to conventional health care services. In particular, young women who did not seek help for their depression were more likely to self-prescribe CAM than were women without depression.

Conclusion

The frequent use of a range of conventional providers and practitioner-based CAM and self-prescribed CAM among women with self-reported depression warrants further investigation.

Section snippets

Health service use among persons with depressive symptoms

Although effective treatments for depression have long been available, previous studies have indicated that this condition tends to be seriously underdiagnosed and undertreated (Economic Working Group Advisory Board, 2005, Wang et al., 2005). The ALSWH discovered that 60% of younger women who reported a diagnosis of depression had no claims in the government-subsidized Pharmaceutical Benefits Scheme for any antidepressant medication in 2005, and 40% had no claims at any time during the period

Sample

This research was conducted as part of the ALSWH, which was designed to investigate multiple factors affecting the health and well-being of women over a 20-year period. Relevant ethical approval was gained from the Human Ethics Committee at the University of Queensland and University of Newcastle, Australia. Women in three age groups (young, 18–23; mid-age 45–50; and older, 70–75 years) were randomly selected from the national Medicare database (Brown et al., 1998). The focus of this study is

Results

Depression status in this study was defined by self-report to a single question in the ALSWH survey. There were 7,164 women who answered the question regarding depression in Survey 4 (2006) and the prevalence of self-reported depression at this time point was 34%. The percentage of women who sought help for their depression was 10.5% (n = 749). The analyses were restricted to the two most recent ALSWH surveys (2003 and 2006). Table 1, Table 2, Table 3 summarized the findings of the 2006 survey,

Discussion

A number of design features of our study provide strength to our data and analysis. In addition to providing longitudinal analysis and examining the use of a broad range of treatment and provider options available, one major strength of our study is the examination of data from a large nationally representative sample of women.

The findings of this study confirm the results of previous research indicating that depression is a disorder that is seriously underreported and undertreated (Economic

Conclusion

This article reports on findings of a longitudinal study on patterns of health service consumption among young women with self-reported depression. The study highlights that only a small proportion of women with self-reported depression had sought professional assistance for their problem. It also reveals that many women with self-reported depression used CAM alongside or as a complement to conventional health care service. In particular, young women who did not seek help for their depression

Acknowledgment

The research on which this article was based was conducted as part of the ALSWH, which is funded by the Australian Government Department of Health and Ageing (DOHA). We are grateful to the DOHA for funding and to the women who provided the survey data.

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