Baltimore, four interviews over 24 years: 69 percent of antidepressant users never met criteria for major depression
Of people currently taking an antidepressant, "69% never met criteria for major depressive disorder (MDD); and 38% never met criteria for" any of five common mood and anxiety disorders in their lifetime.
Reasonable evidence with real limitations. how we score evidence
Caveat on this rating: One city and a cohort that aged over the study. Structured lay interviews can miss disorders a clinician would diagnose, and disorders outside the five assessed (for example PTSD, dysthymia, chronic pain indications) are not counted.
One objection to the no-diagnosis finding is that people forget past illness. This study interviewed the same people four times across twenty four years, so there was less to forget.
Significant findings
Takayanagi and colleagues (Journal of Clinical Psychiatry, 2015) used the Baltimore Epidemiologic Catchment Area Study, "Wave 1 (1981) through Wave 4 (2004-2005) (N = 1,071)", assessing mood and anxiety disorders at each interview.
"Thirteen percent of participants at Wave 4 reported currently using antidepressant medications. Among antidepressant users, 69% never met criteria for major depressive disorder (MDD); and 38% never met criteria for MDD, obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder in their lifetime."
What did predict use: "Female gender, Caucasian ethnicity, recent or current physical problems (eg, loss of bladder control, hypertension, and back pain), and recent mental health facility visits".
The authors: "Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications."
Worth asking
The trials that got these drugs approved enrolled people who met full criteria for a disorder. More than a third of the people taking them in this community never did. For them there is no trial evidence of benefit, while the side effects and the difficulty of stopping are the same. That is not an argument that any one person's prescription is wrong. It is a reason to ask what yours is for. One city, 1,071 people, and the last interview was in 2005. Never stop an antidepressant on your own.
Source
Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiologic Catchment Area Study — Takayanagi Y, Spira AP, Bienvenu OJ, Hock RS, Carras MC, Eaton WW, Mojtabai R (2015)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.4088/JCP.13m08824
DOI: 10.4088/JCP.13m08824
How this was scored
- Study design
- Cohort study
- Funding
- Independently funded
- Published in
- Reputable peer-reviewed journal
- Sample size
- 1,071
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "moderate evidence". Reasonable evidence with real limitations. It scores 65 out of 100 on our published rubric. One caveat travels with that badge: One city and a cohort that aged over the study. Structured lay interviews can miss disorders a clinician would diagnose, and disorders outside the five assessed (for example PTSD, dysthymia, chronic pain indications) are not counted. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiologic Catchment Area Study — Takayanagi Y, Spira AP, Bienvenu OJ, Hock RS, Carras MC, Eaton WW, Mojtabai R (2015). Published in: Reputable peer-reviewed journal. DOI: 10.4088/JCP.13m08824. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Independently funded. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.