Cheer up: U.S. not so depressed

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Melancholy America? Not likely. Research claiming the nation is depressed and dysfunctional is "fiction," said sociologists who blame bad science, political ploys and profiteering for the misinformation.

Community-based mental-health surveys designed to plumb the public mood have "rhetorical value" for policy discussions, scientific studies, news stories, advocacy documents and pharmaceutical ads, say Allan V. Horwitz of Rutgers University and Jerome C. Wakefield of New York University, who revealed their findings yesterday.

But alarming statistics about depression, sexual dysfunction, anxiety disorders or drug and alcohol abuse are exaggerations, the researchers say.

"These numbers are largely a product of survey methodologies that, by nature, overstate the number of people with mental illness," they said in their research, released by the District-based American Sociological Association.

"A good survey provides a good context," Mr. Wakefield said yesterday.

Both sociologists are critical of public surveys that ask questions normally posed in a psychiatrist's office, but with no interviewer present to clarify the proceedings. The results were often "seriously misleading." Many respondents with normal reactions to stressful life events appeared -- statistically at least -- to be unbalanced.

The researchers were critical of the most oft-quoted studies -- the Epidemiologic Catchment Area Study and the National Comorbidity Survey, which were massive federally and privately funded research conducted during the 1980s and '90s, respectively. Thousands of participants were asked to provide a flat "yes" or "no" to such broad questions as, "Have you ever had two weeks or more when you felt sad, blue or depressed?"

According to the National Comorbidity Study, 48 percent of Americans have experienced a mental disorder. Special-interest groups and pharmaceutical manufacturers "routinely cite such figures to show that mental disorder is a public health problem of vast proportions," the researchers said, justifying the need for more funding, medications, therapy or training. Public-school personnel, for example, are now entrusted to screen students for depression.

Pharmaceutical companies have capitalized on the fuzzy statistics, with commercials that focus on "sadness, loneliness, exhaustion and anxiety that are common among normal people," the researchers said.

Adult use of antidepressants tripled from 1988 to 2000, the Department of Health and Human Services reports. Ten percent of women and 4 percent of men now take the medications, which generate about $12 billion in annual sales.

The two researchers also faulted the National Alliance for the Mentally Ill and other groups for benefiting from survey statistics, with "belief that if they can convince politicians that mental illnesses are widespread, they can gain more funding for mental health services." Allocating resources to the "distressed but not disordered" could backfire, however.

"Erasing the distinction between normal and disordered conditions and calling both mental disorders may harm the truly disabled," the authors concluded.