Here is the concern as highlighted in a massive new study just published in the journal Health Affairs and expressed in one of many media sources across the country reporting on study researchers' findings: "the growing role of Americans' busy primary care physicians as first-line providers of mental health care to American patients."

That new reality -- which now far transcends a mere trend -- is disturbing for at least two reasons. First, there is an increased risk of misdiagnosis when a general practitioner or specialist who is not a psychiatrist prescribes antidepressant drugs to patients who are not diagnosed with a mental disorder. Second, patients prescribed such medications are not often referred to a mental health professional for follow-up, which increases the risk for non-treatment of a serious mental condition.

Study researchers, which included mental health professionals and psychiatrists from Johns Hopkins University and Columbia University, examined more than 230,000 patient records from visits to primary care doctors over a 12-year period ending in 2007. What they found was revealing.

Foremost, the records indicated that nearly one in 10 visits resulted in a prescription being written by the general-care doctor for an antidepressant, with a corresponding diagnosis of depression or anxiety disorder accompanying the prescription in only 44 percent of those cases. When a medical specialist who was not a psychiatrist wrote a prescription, a mental disorder was diagnosed less than 13 percent of the time.

This is concerning, says study author Ramin Mojitabai, MD, PhD and professor at Johns Hopkins, because "antidepressant use appears to be becoming concentrated among people with less severe and poorly defined mental health problems."

Researchers note the harried conditions that many primary care doctors work under, and the resulting tendency to "err on the side of treatment" (that is, prescribe) rather than take more time to investigate symptoms and suggest behavioral changes.

They hope that changes, and that additional research on the matter will follow from their study.

Related Resource: Los Angeles Times, "Antidepressants in primary care: is this any way to treat depression?" Aug. 4, 2011