Research reportUtility of the concept of minor depressive disorder: Evidence from a large rural community sample in a developing country setting
Introduction
The well-recognised public health impact of depressive disorders is even more extensive when symptomatic states not meeting established diagnostic criteria for depressive disorders are included (Broadhead et al., 1990, Judd et al., 2002). Extant evidence suggests minor depressive disorder is not usually transient, but is a persistent mood state (Rapaport et al., 2002) with utility in primary care settings, among the elderly and the physically ill (Merikangas et al., 1996). Despite such indicative findings on its usefulness (Angst et al., 1997, Williams et al., 2000, Judd et al., 2004, Smit et al., 2006), different definitions have continued to be used to describe minor depressive disorder in various epidemiological (Pincus et al., 1999, Penninx et al., 1999, Rapaport et al., 2002, Cuijpers et al., 2005), and intervention studies (Williams et al., 2000, Judd et al., 2004) limiting the generalisability of the findings. The impact and relevance of this group of disorders in rural communities and resource-constrained settings is also not evaluated. We assessed the clinical and public health utility of the minor depressive disorder diagnostic construct in a resource-constrained setting based on a survey of a large rural community from Ethiopia.
Section snippets
Study sample
The study was conducted in Butajira district, a predominantly rural district in South-central Ethiopia. Forty-four of the forty-five administrative sub-districts were included, with one sub-district excluded because of physical inaccessibility. The Butajira district has a population of 227,135, with over 100,000 between the ages of 15 and 45 (OPHCC, 1996). Adults, aged 15 to 49 years residing in the study sub-districts, estimated to number 83,282 persons, were included for the study. The upper
Sample characteristics and prevalence
A total of 68,378 adults, aged 15–49 years were interviewed using the CIDI. This is 82% of the target population, estimated to be 83,282. The main reason for non-response was being out of the district on a business trip, which accounted for 65% of all non-response. The demographic characteristic of study population and cases is presented in Table 1. After excluding cases with current and lifetime depressive disorders, mania and hypomania (n = 399), the population at risk was 67,979. The mean age
Prevalence
To our knowledge this is the largest study to examine the utility of the concept of minor depressive disorder in a rural community setting. Despite the increasing interest and acknowledgement of the relevance of subthreshold depressive states over the past 15 years, most studies have used varied definitions to characterise these states. Since the provision of the DSM-IV operational criteria to diagnose minor depressive disorder, there are only very few studies that have strictly followed the
References (34)
- et al.
The role of demographic surveillance systems (DSS) in assessing the health of communities: an example from rural Ethiopia
Public Health
(2002) - et al.
The prevalence, clinical relevance, and public health significance of subthreshold depression
Psychiatr. Clin. North Am.
(2002) - et al.
Prevalence, correlates, and course of minor depression and major depression in the national comorbidity survey
J. Affect. Disord.
(1997) - et al.
Depression amongst Nigerian university students prevalence and sociodemographic correlates
Soc. Psychiatry Psychiatr. Epidemiol.
(2006) - et al.
Suicide attempts among adults in Butajira, Ethiopia
Acta Psychiatr. Scand.
(1999) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV)
(1994)- et al.
Do diagnostic criteria determine the sex ratio in depression
J. Affect. Disord.
(1984) - et al.
Subthreshold syndromes of depression and anxiety in the community
J. Clin. Psychiatry
(1997) - et al.
Unequal access and unmet need: neurotic disorders and the use of primary care services
Psychol. Med.
(2000) - et al.
Depression, disability days, and days lost from work in a prospective epidemiologic survey
JAMA
(1990)
Empirical examination of current depression categories in a population-based study: symptoms, course, and risk factors
Am. J. Psychiatry
Predicting the onset of major depression in subjects with subthreshold depression in primary care: a prospective study
Acta Psychiatr. Scand.
Physical illness and parasuicide: evidence from the European Parasuicide Study Interview Schedule (EPSIS/WHO-EURO)
Int. J. Psychiatry Med.
Lifetime and 12-month prevalence of mental disorders in the Nigerian Survey of Mental Health and Well-Being
B. J. Psychiatry
Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions
Arch. Gen. Psychiatry
Depressive symptoms as relative and attributable risk factors for first-onset major depression
Arch. Gen. Psychiatry
Service utilization and social morbidity associated with depressive symptoms in the community
JAMA
Cited by (17)
Prevalence of suicide attempts across the African continent: A systematic review and meta-analysis
2024, Asian Journal of PsychiatryThe Trends of Suicidality Over the Past 10 Years (1999–2022) in the Ethiopian General Population and the Way Forward in Tackling It
2023, Psychology Research and Behavior ManagementUnemployment associated with major depression disorder and depressive symptoms: a systematic review and meta-analysis
2022, International Journal of Occupational Safety and ErgonomicsPrevalence of suicidal ideation and attempted suicide in the general population of Ethiopia: a systematic review and meta-analysis
2021, International Journal of Mental Health SystemsHelp-seeking preferences to informal and formal source of care for depression: A community-based study in northwest ethiopia
2021, Patient Preference and Adherence