Abstract：
Depression is an eminently treatable disorder that responds to psychotherapy or medications; the efficacy of each has been established in hundreds of controlled trials. Nonetheless, the prevalence of depression has increased in recent years despite the existence of efficacious treatments-a phenomenon known as the treatment-prevalence paradox. We consider several possible explanations for this paradox, which range from a misunderstanding of the very nature of depression, inflated efficacy of the established treatments, and a lack of access to efficacious delivery of treatments. We find support for each of these possible explanations but especially the notion that large segments of the population lack access to efficacious treatments that are implemented as intended. We conclude by describing the potential of using lay therapists and digital technologies to overcome this lack of access and to reach historically underserved populations and simultaneously guarantee the quality of the interventions delivered.
摘要：
抑郁症是一种对心理治疗或药物有反应的可治疗的疾病；每种疾病的疗效已在数百项对照试验中确立。尽管如此，尽管存在有效的治疗方法,但近年来抑郁症的患病率仍在增加,这种现象被称为治疗-患病率悖论.我们考虑这个悖论的几种可能的解释，这包括对抑郁症本质的误解，已建立的治疗方法的功效膨胀，缺乏有效的治疗方法。我们发现这些可能的解释中的每一个都得到了支持，尤其是很大一部分人群无法获得按预期实施的有效治疗的观点。最后，我们描述了使用非专业治疗师和数字技术来克服这种缺乏机会并覆盖历史上服务不足的人群并同时保证所提供干预措施的质量的潜力。
