Antidepressants are widely used to treat
depression in
Korea, however, only a few studies have focused on the provider of the
treatment. The aim of the study is to compare the differences between
patients who were prescribed
antidepressants by
psychiatrists and those
who were prescribed
antidepressants by non-
psychiatrists in
South Korea.
Patients with a
diagnosis of
depressive disorder who had been newly prescribed
antidepressants in 2012 were selected from the
Health Insurance Review and Assessment Service database. They were classified into two groups depending on whether they received the
antidepressant prescription from a
psychiatrist or non-
psychiatrist. Sociodemographic, clinical, and
depression related
cost has been investigated.
Treatment resistant depression, which is defined as a failure of two
antidepressant regimens to alleviate symptoms, was also investigated.
Prescription adequacy was assessed based on whether a regimen was maintained for at least 4 weeks. Among the 834694
patients with pharmaceutically treated
depression (PTD) examined in this study, 326122 (39.1%) were treated by
psychiatrists.
Patients who were treated by
psychiatrists were younger and had more psychiatric comorbidities than those treated by non-
psychiatrists. They had longer PTD duration (229.3 days vs. 103.0 days, p < 0.05) and a larger proportion of
treatment resistant depression (9.3% of PTD) when compared to those
patients treated by non-
psychiatrists. The
patients treated by
psychiatrists had a smaller proportion of inadequate
antidepressant use compared to those
patients in the non-
psychiatrist group (44.5% vs. 65.1%, p < 0.05). The
costs related to
depression corrected with PTD duration were higher in the nonpsychiatrist group (32214 won vs. 56001 won, p < 0.05).
Patients who receive
antidepressants from
psychiatrists are
patients with more severe,
treatment-resistant
depression.
Psychiatrists prescribe
antidepressants more adequately and
cost-effectively than non-
psychiatrists.