Antidepressant Use among Blacks and Whites in the United States

Objective—The study objective was to estimate the prevalence and correlates of antidepressant use by black and white Americans. Methods—Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) were analyzed to calculate nationally representative estimates of antidepressant use by black and white Americans. Setting—The 48 coterminous United States was the setting. Participants—Household residents ages 18 years and older (N=9,723) participated in the study. Main Outcomes—The primary outcome was past-year antidepressant use (n=1,004). Results—Among individuals with 12-month depressive and anxiety disorders (n=516), blacks (14.6%) had significantly lower (p < 0.001) antidepressant use than whites (32.4%). Depression severity was significantly associated with higher antidepressant use for whites, but not blacks. Psychiatric disorders and vascular disease significantly increased the odds of past-year antidepressant use. The increased prevalence of antidepressant use associated with vascular disease was independent of diagnosable psychiatric disorders. Among respondents not meeting criteria for 12-month depressive and anxiety disorders, lifetime depressive and anxiety disorders and vascular disease significantly increased the odds of antidepressant use. Conclusions—Few white and fewer black Americans with depressive and anxiety disorders receive antidepressant treatment. Higher depression severity was associated with more antidepressant use for whites, but not blacks. Antidepressant use was associated with medical conditions related to vascular disease, and these medical conditions were independent of coexisting psychiatric conditions. The results also indicate that many antidepressants are used for maintenance pharmacotherapy for Corresponding Author: Hector M. González, Institute of Gerontology, Wayne State University, 87 East Ferry Street, 226 Knapp Building, Detroit, MI 48202, Phone: (313) 577-2297, Fax: (313) 875-0127 Email: [email protected]. Financial Disclosures: The authors report no conflicts of interest that could inappropriately influence, or be perceived to influence, this work. Disclosures: None for any author. NIH Public Access Author Manuscript Psychiatr Serv. Author manuscript; available in PMC 2008 November 12. Published in final edited form as: Psychiatr Serv. 2008 October ; 59(10): 1131–1138. doi:10.1176/appi.ps.59.10.1131. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript depressive and anxiety disorders as well as common medical conditions associated with vascular disease.