[Use of health services and treatments for major depressive episode in France].

INTRODUCTION

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.

OBJECTIVES

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.

METHOD: 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.

RESULTS

- 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.

CONCLUSION

- 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.