Article

The Epidemiology of Chronic Major Depressive Disorder and Dysthymic Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Department of Psychiatry, College of Physicians and Surgeons New York State Psychiatric Institute, New York, New York, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 12/2010; 71(12):1645-56. DOI: 10.4088/JCP.09m05663gry
Source: PubMed

ABSTRACT To examine the prevalence of chronic major depressive disorder (CMDD) and dysthymic disorder, their sociodemographic correlates, patterns of 12-month and lifetime psychiatric comorbidity, lifetime risk factors, psychosocial functioning, and mental health service utilization.
Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093).
The 12-month and lifetime prevalences were greater for CMDD (1.5% and 3.1%, respectively) than for dysthymic disorder (0.5% and 0.9%, respectively). Individuals with CMDD and dysthymic disorder shared most sociodemographic correlates and lifetime risk factors for major depressive disorder. Individuals with CMDD and dysthymic disorder had almost identically high rates of Axis I and Axis II comorbid disorders. However, individuals with CMDD received higher rates of all treatment modalities than individuals with dysthymic disorder.
Individuals with CMDD and dysthymic disorder share many sociodemographic correlates, comorbidity patterns, risk factors, and course. Individuals with chronic depressive disorders, especially those with dysthymic disorder, continue to face substantial unmet treatment needs.

Download full-text

Full-text

Available from: Mayumi Okuda, Aug 20, 2015
2 Followers
 · 
177 Views
  • Source
    • "Experimental studies have shown that, compared to employed controls without dysthymia, those with dysthymia have poorer work performance and at-work productivity [12,18,20–23]. Despite the availability of effective treatments for dysthymia and the condition's known adverse psychosocial consequences, including those affecting employment, patients with dysthymia are frequently undertreated [3] [24]. Conflicting findings regarding the effectiveness of medications and psychotherapeutic approaches for improving symptoms remain a barrier to care. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To test the effectiveness of a work-focused intervention (WFI) on the work outcomes of employed adults with dysthymia. This subgroup analysis from a randomized controlled trial compares an initial sample of 167 employees (age: ≥45 years), screened for dysthymia using the PC-SAD without current major depressive disorder randomized to WFI (n=85) or usual care (UC) (n=82). Study sites included 19 employers and five additional organizations. Telephone-based WFI counseling (eight, twice monthly 50-min sessions) provided work coaching and modification, care coordination and cognitive behavioral therapy. Adjusted mixed effects models compared the WFI vs. UC group preintervention to 4-month postintervention change in at-work limitations measured by the Work Limitations Questionnaire. Secondary outcome analysis compared the change in self-reported absences and depression symptom severity (Patient Health Questionnaire PHQ-9 scores). Work productivity loss scores improved 43.0% in the WFI group vs. 4.8% in UC (difference in change: P<.001). Absence days declined by 58.3% in WFI vs. 0.0% in UC (difference in change: P=.09). Mean PHQ-9 depression symptom severity declined 44.2% in WFI vs. 5.3% in UC (difference in change: P<.001). At 4 months, the WFI was more effective than UC on two of the three outcomes. It could be an important mental and functional health improvement resource for the employed dysthymic population. Copyright © 2015. Published by Elsevier Inc.
    General hospital psychiatry 04/2015; 37(4). DOI:10.1016/j.genhosppsych.2015.04.001 · 2.90 Impact Factor
  • Source
    • "gether with chronic major depressive disorder – vary widely from 0 . 1% to 2 . 5% ( Gureje , 2011 ; Baumeister and Harter , 2007 ) . Nationally representative popula - tion surveys carried out in Western countries report prevalence rates from 1 . 1% to 2 . 5% , but figures as low as 0 . 5% have been found in the US ( Baumeister and Harter , 2007 ; Blanco et al . , 2010 ) . A recent systematic review found a global pooled prevalence of 1 . 6% . The prevalence peaked at 50 years and was higher in men than women ( Charlson et al . , 2013 ) . Our finding of a 4 . 5% prevalence is significantly higher than this , and could be related to the age distribution in our study , in addition to the impact of imput"
    [Show abstract] [Hide abstract]
    ABSTRACT: Up-to-date epidemiological data on depressive disorders is needed to understand changes in population health and health care utilization. This study aims to assess the prevalence of major depressive disorder (MDD) and dysthymia in the Finnish population and possible changes during the past 11 years. In a nationally representative sample of Finns aged 30 and above (BRIF8901), depressive disorders were diagnosed with the Composite International Diagnostic Interview (M-CIDI) in 2000 and 2011. To account for nonresponse, two methods were compared: multiple imputation (MI) utilizing data from the hospital discharge register and from the interview in 2000 and statistical weighting. The MI-corrected 12-month prevalence of MDD was 7.4% (95% CI 5.7-9.0) and of dysthymia was 4.5% (95% CI 3.1-5.9), whereas the corresponding figures using weights were 5.4% (95% CI 4.7-6.1) for MDD and 2.0% (95% CI 1.6-2.4) for dysthymia. Women (OR 2.33, 95% CI 1.6-3.4) and unmarried people (OR 1.54, 95% CI 1.2-2.0) had a higher risk of depressive disorders. There was a significant increase in the prevalence of depressive disorders during the follow-up period from 7.3% in 2000 to 9.6% in 2011. Prevalences were two percentage points higher, on average, when using MI compared to weighting. Hospital treatments for depressive disorders and other mental disorders were strongly associated with nonparticipation. The CIDI response rate dropped from 75% in 2000 to 57% in 2011, but this was accounted for by MI and weighting. Depressive disorders are a growing public health concern in Finland. Non-participation of persons with severe mental disorders may bias the prevalence estimates of mental disorders in population-based studies. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 11/2014; 173C:73-80. DOI:10.1016/j.jad.2014.10.015 · 3.71 Impact Factor
  • Source
    • "Major depressive disorder (MDD) is one of the most widespread psychiatric disorder [1] [2] [3] [4] and the leading cause of disability as measured by years lived with disability (YLDs) [5] [6] [7] [8] [9]. Currently, MDD is estimated to be the fourth leading cause of global disease burden [10] [11], and, by the year 2020, it is projected to reach the second place in the ranking of the major causes of Disability Adjusted Life Years (DALYs). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives and Methods. The aim of the present study was to evaluate, by means of receiver operating characteristic (ROC) curves, whether cognitive vulnerabilities (CV), as measured by three well-known instruments (the Beck Hopelessness Scale, BHS; the Life Orientation Test-Revised, LOT-R; and the Attitudes Toward Self-Revised, ATS-R), independently discriminate between subjects with different severities of depression. Participants were 467 young adults (336 females and 131 males), recruited from the general population. The subjects were also administered the Beck Depression Inventory-II (BDI-II). Results. Four first-order (BHS Optimism/Low Standard; BHS Pessimism; Generalized Self-Criticism; and LOT Optimism) and two higher-order factors (Pessimism/Negative Attitudes Toward Self, Optimism) were extracted using Principal Axis Factoring analysis. Although all first-order and second-order factors were able to discriminate individuals with different depression severities, the Pessimism factor had the best performance in discriminating individuals with moderate to severe depression from those with lower depression severity. Conclusion. In the screening of young adults at risk of depression, clinicians have to pay particular attention to the expression of pessimism about the future.
    Depression research and treatment 08/2013; 2013:407602. DOI:10.1155/2013/407602
Show more