Depression treatment impacted by socioeconomic factors, new study finds

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By Liz Gold

Patients with lower income, education, and those who are classified as minorities tend to have worse treatment outcomes when seeking support for depression, according to a new study.

New research conducted by the University of Cincinnati and published in the journal, Psychiatric Services, examined the impact of socioeconomic variables on outcomes of pharmacotherapy treatments for major depressive disorder in analyses that controlled for treatment access and level of care.

Using data from the Combining Medications to Enhance Depression Outcomes study, the research was conducted from March 2008 to April 2014 with 665 adults who had major depressive disorder and were randomly assigned to three pharmacotherapeutic treatments. Authors evaluated the effects of education, income, race-ethnicity, and employment on treatment outcomes.

According to the study’s results, after sex, age, and treatment type were controlled for in the analyses, and following 12 weeks of antidepressant medication treatment, researchers found that not having a college education, being unemployed, or being non-white were each associated with slower and less improvement from treatment for depression. At the end of the treatment week (week 12), not having a college degree reduced treatment responses by almost 9.6 percent, being unemployed by 6.6 percent, and being non-white by 11.3 percent. The study authors also found that treatment response was significantly related to income – having an income at the 25^th percentile of the income distribution decreased improvement by 4.8 percent compared with having an income at the 75^th percentile.

One of the study’s authors, Jeffrey Mills, PhD, said that the findings do not negate the fact that a lack of access makes an impact on treatment outcomes, but it does show the importance of including a patient’s home environment when analyzing the effectiveness of treatment.

“If you’re going home to a wealthy neighborhood with highly educated parents or spouse, then you’re arguably in a much better environment for the treatment to be effective than if you’re going to a poor neighborhood with other problems,” said Mills, professor of economics in UC’s Carl H. Lindner College of Business in a statement.