Cross-national epidemiology of DSM-IV major depressive episode.
Abstract
ABSTRACT: BACKGROUND: Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low-middle income countries. This paper presents data on the prevalence, impairment, and demographic correlates of depression from 18 high and low-middle income countries in the World Mental Health Survey Initiative. METHODS: DSM-IV major depressive episodes (MDE) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults. RESULTS: The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the 10 high income and 11.1% and 5.9% in the 8 low-middle income countries. The average age of onset ascertained retrospectively was 25.7 in high and 24.0 in low-middle income countries. Functional impairment was associated with recency of MDE. The female:male ratio was about 2:1. In high income countries, younger age was associated with higher 12-month prevalence; in several low-middle income countries, in comparison, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high income countries was being separated and in low-middle income countries was being divorced or widowed. CONCLUSIONS: MDE is a significant public health problem across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH.
Domains
Psychiatrics and mental health
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