We present a cross-sectional analysis of 1391 outpatients and 280 inpatients participating in subprojects of the Research Training Group POKAL, of whom 1609 had a PHQ-9 score ≥ 5 and 62 reported depression with antidepressant use. Antidepressant use was lower among outpatients than inpatients (28.5% vs. 82.5%), with higher levels of SSRI monotherapy (44.1% vs. 25.5%). Of antidepressant users, 80.1% had potentially inadequate treatment response, 21.7% high-risk use and of those with severe symptoms, 42.1% were potentially undertreated. Key risk factors were higher anxiety levels (for inadequate treatment response) and polypharmacy (for high-risk use), while previous depressive episode was protective against potential undertreatment.
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