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The Epidemiology of Depression
Lifetime Prevalence of Major Depressive Disorder by Age
Total (%)
18-29 (%)
30-44 (%)
45-59 (%)
60+
Major depressive disorder 16.6 15.4 19.8 18.8 10.6
Source: Kessler RC et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593-602.
Compared to adults over the age of 60 years, 18-29 year olds are 70% more likely to have
experienced depression over their lifetime 30-44 year olds are 120% more likely 45-49 year olds are 100% more likely
While major depression is less common among the elderly, 12-20% suffer from some depressive symptoms
Twelve-Month Prevalence of Major Depressive Disorder by Severity
Total (%)
Serious (% of all cases)
Moderate (% of all cases)
Mild (% of all
cases)
Major depressive disorder 6.7 30.4 50.1 19.5
Source: Kessler RC et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593-602.
Incidence and Age of Onset (AOO)
First onset incidence: 1.6 per 100Average age of onset: 32 years old
Source: National Institute of Mental Health.
Subtypes of Major Depression
Subtypes Major depression with psychotic features (~14% of
depression) More severe course than nonpsychotic depression Increased risk of relapse, persistence over one year,
suicide attempts, hospitalization, comorbidity, financial dependency
Major depression with atypical features E.g., overeating and oversleeping Younger age of onset, more psychomotor slowing, more
comorbid panic disorder, drug abuse/dependence, and somatization disorder relative to depression without atypical features
Source: Horwath, Cohen, Weissman. Epidemiology of Depressive and Anxiety Disorders. In: Textbook in Psychiatric Epidemiology, MT Tsuang and M Tohen, eds. (2nd edition). Wiley-Liss, 2002: New York.
The Global Burden of Disease
The Global Burden of Disease Study conducted by the World Health Organization found that depression was one of the most disabling diseases in the world Due to the number of Disability-Adjusted Life Years (DALYs) and Years of
Life Lost (YLL) associated with the disease, depression ranked as the fourth most disabling disease in the world
Source: Horwath, Cohen, Weissman. Epidemiology of Depressive and Anxiety Disorders. In: Textbook in Psychiatric Epidemiology, MT Tsuang and M Tohen, eds. (2nd edition). Wiley-Liss, 2002: New York.
Sociodemographic Factors Associated with Depression
Women are 70% more likely than men to experience depression during their lifetime
Non-Hispanic blacks are 40% less likely than non-Hispanic whites to experience depression during their lifetime
Age is associated with depression, with the strongest association among 30-44 year olds
Lower level of education and employment classification Homemakers
Separated, divorced, or widowed
Sources: National Institute of Mental Health
Family History
Depression tends to cluster in familiesFirst-degree relatives of individuals with
major depression have a 2-3 fold increased risk of disease
Concordance of depression is higher in monozygotic twin pairs (27%) relative to dizygotic twin pairs (12%), suggesting a genetic contribution
Source: Horwath, Cohen, Weissman. Epidemiology of Depressive and Anxiety Disorders. In: Textbook in Psychiatric Epidemiology, MT Tsuang and M Tohen, eds. (2nd edition). Wiley-Liss, 2002: New York.
Comorbid Conditions
Dysthymic disorder is associated with a five-fold increase of depression
Schizophrenia is associated with ~3-fold increase in first-onset major depression
50-60% of individuals with a lifetime history of major depression have a history of one or more anxiety disorders
Source: Horwath, Cohen, Weissman. Epidemiology of Depressive and Anxiety Disorders. In: Textbook in Psychiatric Epidemiology, MT Tsuang and M Tohen, eds. (2nd edition). Wiley-Liss, 2002: New York.
Suicide
In 2007, suicide was the tenth leading cause of death in the United States Third leading cause of death for young people ages
15-24 years
There are an estimated 11 attempted suicides per every suicide death
Source: National Institute of Mental Health
Risk Factors for SuicideDepression and other mental disorders, substance-
abuse disorderPrior suicide attemptFamily history of mental disorder or substance
abuse, suicideFamily violenceFirearms in the home (used in more than half of
suicides)IncarcerationExposure to the suicidal behavior of others
(family, peers, or media figures)
Source: National Institute of Mental Health
Sociodemographic Factors Associated with Suicide
Highest rates among American Indian and Alaska Natives (14.3 per 100,000) and Non-Hispanic Whites (13.5 per 100,000)
Lower rates among Asian and Pacific Islanders (6.2 per 100,000); Hispanics (6.0 per 100,000); non-Hispanic Blacks (5.1 per 100,000)
Source: National Institute of Mental Health
Risk Factors for Suicide
~4 times as many men as women die by suicide
Firearms, suffocation, and poison are the most common methods of suicide Firearms are used in 56% of male suicides, 30% of
female suicides Poisoning is used in 40% of female suicides, 13% of
male suicides
Source: National Institute of Mental Health
Suicide Rates in the United States