When Depression Goes Untreated

More than 16 million Americans will experience a depressive episode in a given year, yet nearly a third of them will not seek help. A team of researchers sought to identify who those people are and what barriers stand in their way.

The group analyzed more than 20,000 participants who were diagnosed with depression. They applied a machine learning algorithm to six years worth of survey responses that identified commonalities among those who did not seek treatment, such as feeling hopeless or suicidal. When applied to a seventh year of data, the model correctly predicted 72 percent of people who did not initiate treatment. It could also predict, at a rate slightly better than chance, whether a particular barrier applied to a patient for 10 of the 15 reasons studied.

The tool could eventually alert clinicians if a patient is unlikely to seek further treatment—and allow them to tailor appointments to the specific challenges each patient faces, says lead author Adam Chekroud of the Yale School of Medicine. What might those challenges be? Cost was the most common, cited by nearly half of those surveyed. The runners-up included thinking one could overcome the disorder oneself and not knowing where to seek treatment.

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