JMIR Publications

ABSTRACT

Background:

Depression is a prevalent psychiatric condition with functional and socioeconomic consequences. Understanding the barriers to professional help-seeking and treatment acceptance among individuals with depressive symptoms is important.

Objective:

To quantify depression screening positivity and examine treatment-seeking intention, willingness to use antidepressants, and perceived barriers among Korean adults, with attention to prior depression-related healthcare experiences.

Methods:

A cross-sectional online survey was conducted in South Korea (March 16–April 5, 2024) via paid social media advertising and messaging app invitations. A total of 1,053 adults aged ≥20 years participated in this study. Depression screening was conducted using two Primary Care Evaluation of Mental Disorders (PRIME-MD)-derived items, with the endorsement of either item defining a positive screen. History of depression diagnosis or treatment, intentions toward professional treatment, antidepressant use, and perceived barriers were assessed.

Results:

Overall, 65.0% of the participants had a positive depression screen. A positive depression screen was not significantly associated with the intention to seek professional treatment for depression (adjusted odds ratio [aOR] 1.04, 95% confidence interval [CI] 0.77–1.41). Participants with a positive depression screen had lower odds of being willing to take antidepressants than those with a negative screen (aOR 0.73, 95% CI 0.54–0.99). A within-participant analysis showed that the association of depression screening status differed between treatment-seeking intention and willingness to take antidepressants (ratio of odds ratios 0.70, 95% CI 0.53–0.94; P for interaction=.018). The joint response of intending to seek treatment while being unwilling to take antidepressants was more common among participants with a positive than a negative depression screen (11.0% vs. 6.2%; aOR 1.70, 95% CI 1.04–2.77). A history of depression diagnosis or treatment was positively associated with treatment-seeking intention and willingness to use antidepressants. Among screen-positive adults, those without such a history more often reported that they would not seek treatment if diagnosed with depression (25.5% vs. 14.5%; P=.002) or would be unwilling to take antidepressants if recommended (30.5% vs. 16.2%; P<.001). Barriers profiles to treatment-seeking differed by history of depression diagnosis or treatment (P for interaction<.001), whereas the patterns of reasons for unwillingness to take antidepressants did not differ according to the history (P for interaction=.080).

Conclusions:

In this online survey sample, a positive depression screen was associated with a lower willingness to use antidepressants but not with treatment-seeking intention. Among screen-positive participants, those without prior depression-related healthcare experience contact had lower help-seeking intention and willingness to take antidepressants than those with prior contact, suggesting the need to reduce barriers to care and support earlier treatment initiation.