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Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature

Published online by Cambridge University Press:  25 July 2012

A. J. Ferrari ,
A. J. Somerville ,
A. J. Baxter ,
R. Norman ,
S. B. Patten ,
T. Vos  and
H. A. Whiteford
A. J. Ferrari*
Affiliation:
The University of Queensland, School of Population Health, Herston, QLD, Australia Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
A. J. Somerville
Affiliation:
The University of Queensland, Institute of Social Science Research, St Lucia, QLD, Australia
A. J. Baxter
Affiliation:
The University of Queensland, School of Population Health, Herston, QLD, Australia Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
R. Norman
Affiliation:
The University of Queensland, School of Population Health, Herston, QLD, Australia The University of Queensland, Queensland Children's Medical Research Institute, Herston, QLD, Australia
S. B. Patten
Affiliation:
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
T. Vos
Affiliation:
The University of Queensland, School of Population Health, Herston, QLD, Australia
H. A. Whiteford
Affiliation:
The University of Queensland, School of Population Health, Herston, QLD, Australia Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
*
*Address for correspondence: A. J. Ferrari, Policy and Evaluation Group, Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Locked Bag 500, Sumner Park BC, Brisbane, QLD 4074, Australia. (Email: [email protected])
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Abstract

Background

Summarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study.

Method

A systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis.

Results

The literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4–5.0%). The pooled annual incidence was 3.0% (2.4–3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD.

Conclusions

Our findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.

Keywords

Epidemiologyglobal burden of diseaseincidencemajor depressive disordermeta-regressionprevalence
Type
Review Article
Information
Psychological Medicine , Volume 43 , Issue 3 , March 2013 , pp. 471 - 481
Copyright
Copyright © Cambridge University Press 2012

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