The Costs of Depression

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Prevalence

Weissman and colleagues6 published the first cross-national data on the prevalence of MDD, using the same methods as, the landmark US Epidemiologic Catchment Area Study.7 Lifetime prevalence estimates in these surveys were in the range of 1.5% to 19.0%, with a midpoint of 9.4% and generally higher rates in higher income than lower income countries. Twelve-month prevalence estimates were in the range of 0.8% to 5.8%, with a midpoint of 3.7%. Subsequent studies8 using a diagnostic interview

Course of Illness

Few large-scale, longitudinal, general population studies of MDD exist, but clinical studies show that a substantial proportion of people who seek treatment for major depression have a chronic–recurrent course of illness.13, 14 Subtyping is complicated by the fact that chronic depression subtypes are poorly understood.15 The community survey finding that lifetime prevalence is 2 to 3 times that of 12-month prevalence suggests that between one third and one half of lifetime cases have recurrent

Life Course Role Incumbency, Timing, and Transitions

Given their typically early age of onset, mental disorders might be expected to have adverse effects on critical developmental transitions, such as educational attainment and timing of marriage. A number of epidemiologic studies have examined these effects, with a focus on 4 domains: Education, marital timing and stability, childbearing, and occupation.

Education

Several studies show early-onset mental disorders associated with termination of education.19, 20, 21, 22, 23, 24, 25, 26 Although disruptive

Summary

The data reported herein show clearly that major depression is a commonly occurring and burdensome disorder. The high prevalence, early age of onset, and high persistence of MDD in the many different countries where epidemiologic surveys have been administered confirm the high worldwide importance of depression. Although evidence is not definitive that MDD plays a causal role in its associations with the many adverse outcomes reviewed here, there is clear evidence that depression has causal

Disclosure

This report was prepared in conjunction with the author's participation in the World Health Organization World Mental Health (WMH) Survey Initiative. WMH is supported by the United States National Institute of Mental Health (R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, the Eli Lilly &

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