The devil in the details: depression and public health (original) (raw)
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Global burden of depressive disorders: the issue of duration
The British Journal of Psychiatry, 2002
Comparing age at onset of major depression and other Comparing age at onset of major depression and other psychiatric disorders by birth cohorts in five US psychiatric disorders by birth cohorts in five US community populations. community populations. Archives of General Psychiatry Archives of General Psychiatry, , 48 48, 789^795. , 789^795. Costello, C. G. (1990) Costello, C. G. (1990) The similarities and dissimilarities The similarities and dissimilarities between community and clinic cases of depression. between community and clinic cases of depression.
Global burden of depressive disorders in the year 2000
The British Journal of Psychiatry, 2004
Background The initial Global Burden of Disease study found that depression was the fourth leading cause of disease burden, accounting for 3.7% of total disability adjusted life years (DALYs) in the world in 1990. Aims To present the new estimates of depression burden for the year 2000. Method DALYs for depressive disorders in each world region were calculated, based on new estimates of mortality, prevalence, incidence, average age at onset, duration and disability severity. Results Depression is the fourth leading cause of disease burden, accounting for 4.4% of total DALYs in the year 2000, and it causes the largest amount of non-fatal burden, accounting for almost 12% of all total years lived with disability worldwide. Conclusions These data on the burden of depression worldwide represent a major public health problem that affects patients and society.
Loss of productivity due to depression is of growing concern in Europe. Implementing effective measures to promote resilience and prevent depression will potentially result in huge societal savings. A major reduction in the incidence of depression throughout Europe is feasible using existing prevention methods.
Global burden of depression: the intersection of culture and medicine
The British Journal of Psychiatry, 2003
The statistics about depression clearly identify it as a major public health problem (Greenberg et al, 1993). About 6% of the population meet the criteria for major depressive disorder or dysthymia at any time, and 20% of those with major depressive disorder will have symptoms that persist beyond 2 years (Keller et al, 1992). The disorder is highly recurrent; 30% of individuals experience a relapse within 3 months of recovery and (in the absence of continuation or maintenance treatment) 50% experience a further episode within 2 years. The standardised mortality ratios for unipolar depression for accidental deaths, for deaths by natural causes and for suicide were 1.4, 1.7 and 19.7, respectively (Ustun, 1999). In the National Health Service the cost of treating depression ($887 million) exceeds the cost of treating both hypertension ($439 million) and diabetes ($300 million) (Department of Health, 1996). However, the direct health care costs are dwarfed by the indirect costs (Berndt ...
2007
Background Depression is an important public-health problem, and one of the leading causes of disease burden worldwide. Depression is often comorbid with other chronic diseases and can worsen their associated health outcomes. Few studies have explored the eff ect of depression, alone or as a comorbidity, on overall health status. Methods The WHO World Health Survey (WHS) studied adults aged 18 years and older to obtain data for health, health-related outcomes, and their determinants. Prevalence of depression in respondents based on ICD-10 criteria was estimated. Prevalence values for four chronic physical diseases-angina, arthritis, asthma, and diabetes-were also estimated using algorithms derived via a Diagnostic Item Probability Study. Mean health scores were constructed using factor analysis and compared across diff erent disease states and demographic variables. The relation of these disease states to mean health scores was determined through regression modelling. Findings Observations were available for 245 404 participants from 60 countries in all regions of the world. Overall, 1-year prevalence for ICD-10 depressive episode alone was 3•2% (95% CI 3•0-3•5); for angina 4•5% (4•3-4•8); for arthritis 4•1% (3•8-4•3); for asthma 3•3% (2•9-3•6); and for diabetes 2•0% (1•8-2•2). An average of between 9•3% and 23•0% of participants with one or more chronic physical disease had comorbid depression. This result was signifi cantly higher than the likelihood of having depression in the absence of a chronic physical disease (p<0•0001). After adjustment for socioeconomic factors and health conditions, depression had the largest eff ect on worsening mean health scores compared with the other chronic conditions. Consistently across countries and diff erent demographic characteristics, respondents with depression comorbid with one or more chronic diseases had the worst health scores of all the disease states. Interpretation Depression produces the greatest decrement in health compared with the chronic diseases angina, arthritis, asthma, and diabetes. The comorbid state of depression incrementally worsens health compared with depression alone, with any of the chronic diseases alone, and with any combination of chronic diseases without depression. These results indicate the urgency of addressing depression as a public-health priority to reduce disease burden and disability, and to improve the overall health of populations.
The impact of depression is unevenly distributed in the population
European Psychiatry, 2005
Aims. -The aim of this study was to evaluate the impact of depression on quality of life in the general population by studying its effects on i) health-related quality of life (HRQoL), ii) health state utilities, and iii) the burden of disease in the population according to age, sex, marital status, education, economy and employment.
The Lancet Public Health, 2021
Background We aimed to estimate the prevalence of current depressive disorder in 27 European countries, and to explore differences in prevalence between European countries and by gender. Methods In this population-based study, we analysed data from respondents living in 27 European countries who were included in the second wave of the European Health Interview Survey, collected between 2013 and 2015. We assessed the prevalence of current depressive disorder using the eight-item Patient Health Questionnaire (PHQ-8), with depressive disorder defined as a PHQ-8 score of 10 or higher. Prevalence estimates and 95% CIs were calculated for all 27 countries overall and for each country individually. We assessed variation in prevalence (country vs the rest of Europe) using crude and adjusted prevalence ratios obtained from negative binomial regression models. We did all analyses for the total sample and stratified by gender. Findings Our analysis sample comprised 258 888 individuals, of whom 117 310 (weighted proportion 47•8%) were men and 141 578 (52•2%) were women. The overall prevalence of current depressive disorder was 6•38% (95% CI 6•24-6•52) with important variation across countries, ranging from 2•58% (2•14-3•02) in the Czech Republic to 10•33% (9•33-11•32) in Iceland. Prevalence was higher in women (7•74% [7•53-7•95]) than in men (4•89% [4•71-5•08]), with clear gender differences for all countries except Finland and Croatia. Compared with the other European countries in our sample, those with the highest adjusted prevalence ratios were Germany (1•80 [1•71-1•89]) and Luxembourg (1•50 [1•35-1•66]), and those with the lowest adjusted prevalence ratios were Slovakia (0•28 [0•24-0•33]) and the Czech Republic (0•32 [0•27-0•38]). Interpretation Depressive disorders, although common across Europe, vary substantially in prevalence between countries. These results could be a baseline for monitoring the prevalence of current depressive disorder both at a country level in Europe and for planning health-care resources and services.