Worldwide disparities in treatment rates for major depressive disorder

A meta-analysis of 149 previous studies found that treatment rates for major depressive disorder are low globally, especially in low- and lower-middle-income countries. Between 2000 and 2021, 149 studies on major depressive disorder therapy were reviewed in 84 countries. The meta-analysis shows that treatment rates are low globally and that treatment varies between countries with varying resources.

Severe depressive disorders are expected to be treated at a rate of 33% in high-income countries, but only 8% in low- and middle-income countries. Treatment rates for severe depressive disorder are lower, estimated at 23% in high-income countries and 3% in poor and lower-middle-income countries. Major depressive disorder is undertreated globally, with many people not receiving treatment that meets practice guideline standards.

The Lancet-World Psychiatric Association Commission stresses reducing negative childhood (including neglect and trauma) and life experiences (including depression) to prevent depression. An individual intervention focusing on risk factors like intimate partner violence and life events like bereavement or financial crisis is also required (e.g., smoking, alcohol consumption, inactivity). They support psychological therapies and antidepressants and more intensive and specialised treatments like electroconvulsive therapy (ECT) for severe, refractory forms of the illness.

We must reconsider the availability of appropriate care and treatment facilitators.