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Letters |

Changes in the Treatment of Depression in the United States: 1987-1997—Reply

Mark Olfson, MD; Steven Marcus, PhD; Benjamin Druss, MD; Teri Tanielian, MA; Harold Alan Pincus, MD
JAMA. 2002;287(14):1803-1804. doi:10.1001/jama.287.14.1799.
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In Reply: Dr Rifkin speculates that an increase in the diagnosis and treatment of depression in primary care may be the "common denominator" behind the national increase in depression treatment from 1987 to 1997. Although we believe that primary care has played an important role, other societal factors are likely to be at work as well. In an earlier analysis of national trends in office-based medical practice, we reported that between 1985 and 1993/1994, visits to primary care physicians and psychiatrists for the treatment of depression increased in nearly equal proportion, 90.9% and 89.8%, respectively.1 A recent analysis of the same office-based survey comparing treatment of depression in 1993/1994 and 1996/1997 demonstrates that the role of primary care physicians has increased, supporting Rifkin's speculation.2 Unfortunately, the Medical Expenditure Panel Survey, which we used to document the recent national increase in the treatment of depression, does not collect data on physician specialty.


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