Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 25 5 2022 05 01 Major Depressive Disorder in Iran: Epidemiology, Health Care Provision, Utilization, and Challenges 329 338 10.34172/aim.2022.54 EN Masoumeh Amin-Esmaeili https://orcid.org/0000-0002-3888-3254 Behrang Shadloo https://orcid.org/0000-0003-1884-9371 Afarin Rahimi-Movaghar https://orcid.org/0000-0002-5761-1668 Seyed Mehdi Samimi Ardestani https://orcid.org/0000-0002-2355-9304 Ahmad Hajebi https://orcid.org/0000-0001-8435-0398 Shahab Khatibzadeh Vandad Sharifi Roya Samadi Mohammad Taghi Yasamy https://orcid.org/0000-0001-7204-4713 Mehran Zarghami https://orcid.org/0000-0002-7027-0992 Farshad Farzadfar https://orcid.org/0000-0001-8288-4046 Saeid Shahraz Journal Article 10.34172/aim.2022.54 2021 11 11 2021 12 21 One in eight adults in Iran is estimated to have major depressive disorder (MDD) – a leading cause of disability in the country. Many remain undiagnosed, and some receive only partial treatment. An estimated 60% of those with MDD were reported to have received no treatment during the past year. In this paper, we have critically reviewed the current health-care structure in the country along with prevailing patterns of health-care service utilization. We have addressed the role of psychiatrists, general practitioners (GPs), psychologists, and other health-care personnel in the treatment and care of patients with MDD, with an emphasis on the quality of service provision. In addition, the strengths and weaknesses of primary healthcare (PHC), the health insurance system, and inpatient care have been discussed. We have paid attention to the contextual issues such as mental health literacy, stigma, and healthcare inequity where relevant. Finally, practical recommendations have been provided to improve the quality of care for patients with MDD in Iran.