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: 5.5). 12/2010; 71(12):1645-56. DOI: 10.4088/JCP.09m05663gry
Source: PubMed


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


Available from: Mayumi Okuda,
  • 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 · 2.61 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 · 3.38 Impact Factor
  • Source
    • "Recently, studies on depression have focused on neuroprotection and NSC-proliferation in DG, and an increased number of studies support the hypothesis that acupuncture can be an effective treatment for depression and a rescuer of impaired neurogenesis [19-21]. Our results provide further evidence in supporting this hypothesis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In this study, we investigate the proliferation of adult neural stem cells (NSCs) in a chronic unpredictable stress (CUS) rat model of depression, the effects of electroacupunture (EA) on depressive-like symptoms and the corresponding signaling pathways. SD rats were subjected to 4 weeks of CUS to induce depressive-like behaviors. EA was performed at the Du-20 (Bai-Hui) and GB-34 (Yang-Ling-Quan) acupoints. Rats were injected with BrdU and the brains were cut into sections. Double-labeling with BrdU/Sox2 and p-ERK/Nestin was performed to demonstrate the in vivo proliferation of adult NSCs in hippocampus and ERK activation in NSCs. Hippocampal microdialysates of different groups were collected to observe the in vitro effects on NSCs. After 8 treatments, EA generated a clear antidepressant effect on the stressed rats and promoted the NSC proliferation. ERK activation might be involved in the antidepressant-like effects of EA treatment. Hippocampal microdialysates from EA-treated stressed rats influenced NSCs to form larger neural spheres and exhibit higher p-ERK level in vitro, compared to the untreated stressed rats. Meanwhile, the antidepressant-like effects of EA involved contribution from both acupoint specificity and electrical stimulus. EA might interfere with the hippocampal microenvironment and enhance the activation of ERK signaling pathways. This could mediate, at least in part, the beneficial effects of EA on NSC proliferation and depressive-like behaviors.
    BMC Complementary and Alternative Medicine 10/2013; 13(1):288. DOI:10.1186/1472-6882-13-288 · 2.02 Impact Factor
Show more