Background
Methods
Study design and population
Assessment of depression
Other measures
Statistical analysis
Results
Men | Women | |||
---|---|---|---|---|
GHS-MHS (n = 1911) | DEGS1-MH (n = 1522) | GHS-MHS (n = 2265) | DEGS1-MH (n = 1743) | |
Age group (years), % (95%-CI) | ||||
18–34 | 36.4 (33.5–39.5) | 30.0 (26.9–33.2) | 35.4 (33.0–37.9) | 31.3 (28.8–34.0) |
35–49 | 34.0 (31.4–36.7) | 36.0 (33.1–39.0) | 33.3 (31.0–35.8) | 36.1 (33.4–39.0) |
50–65 | 29.6 (27.0–32.3) | 34.0 (31.3–36.9) | 31.3 (29.3–33.4) | 32.5 (30.0–35.2) |
Socioeconomic status3, % (95%-CI) | ||||
Low | 17.0 (14.7–19.6) | 18.2 (15.4–21.3) | 17.6 (15.4–20.1) | 16.9 (14.5–19.6) |
Medium | 61.4 (58.8–63.9) | 58.3 (54.9–61.6) | 62.9 (60.4–65.4) | 63.1 (59.5–66.6) |
High | 21.7 (19.1–24.5) | 23.5 (20.8–26.5) | 19.4 (17.2–21.9) | 20.0 (17.6–22.6) |
Community size4, % (95%-CI) | ||||
Rural (< 5000 inhabitants) | 20.8 (14.0–29.8) | 15.9 (10.6–23.2) | 18.9 (12.6–27.4) | 14.5 (9.4–21.5) |
Small town (5000 to < 20,000) | 21.9 (14.7–31.5) | 23.8 (17.4–31.7) | 19.9 (13.3–28.5) | 24.0 (17.6–31.8) |
Mid-sized town (20,000 to < 100,000) | 26.7 (19.1–36.0) | 29.2 (22.1–37.6) | 28.7 (20.7–38.3) | 29.8 (22.7–37.9) |
Large town (≥ 100,000) | 30.6 (22.5–40.1) | 31.0 (23.8–39.3) | 32.6 (24.1–42.4) | 31.8 (24.5–40.1) |
Marital status, % (95%-CI) | ||||
Married and living with partner | 63.3 (60.2–66.2) | 57.9 (54.4–61.2) | 65.3 (62.2–68.3) | 59.2 (55.8–62.4) |
Married and not living with partner | 1.9 (1.2–3.0) | 1.7 (1.0–3.0) | 2.9 (2.1–3.9) | 2.5 (1.6–3.7) |
Single (never been married) | 28.9 (26.3–31.7) | 34.3 (31.2–37.6) | 20.7 (18.5–23.0) | 28.1 (25.3–31.0) |
Divorced | 4.9 (3.9–6.3) | 5.2 (3.9–6.9) | 6.7 (5.4–8.3) | 6.9 (5.6–8.6) |
Widowed | 1.0 (0.6–1.6) | 0.9 (0.4–1.9) | 4.4 (3.4–5.7) | 3.4 (2.5–4.7) |
12-month prevalence of MDD
Men | Women | |||||
---|---|---|---|---|---|---|
1997–1999 (n = 1911) | 2009–2012 (n = 1522) | p-value3 | 1997–1999 (n = 2265) | 2009–2012 (n = 1743) | p-value3 | |
Total, % (95%-CI) | 4.9 (3.9–6.1) | 4.2 (3.3–5.4) | 0.363 | 10.0 (8.5–11.8) | 10.5 (8.6–12.8) | 0.728 |
Age group (years), % (95%-CI) | ||||||
18–34 | 4.4 (3.0–6.5) | 4.0 (2.4–6.7) | 0.761 |
8.8 (6.6–11.6)
|
15.6 (11.3–21.0)
|
0.005
|
35–49 | 5.4 (3.9–7.5) | 4.0 (2.4–6.7) | 0.333 | 11.5 (9.2–14.3) | 11.0 (8.1–14.7) | 0.787 |
50–65 | 4.9 (3.4–6.9) | 4.6 (3.1–6.8) | 0.812 |
9.8 (7.3–13.0)
|
5.0 (3.5–7.1)
|
0.002
|
SES, % (95%-CI) | ||||||
Low | 5.6 (2.9–10.5) | 5.1 (2.7–9.5) | 0.864 | 11.7 (8.4–16.0) | 17.0 (11.1–25.2) | 0.128 |
Middle | 5.3 (4.1–6.9) | 4.4 (3.1–6.2) | 0.331 | 10.1 (8.2–12.3) | 9.3 (7.1–12.1) | 0.610 |
High | 3.3 (2.2–5.0) | 3.1 (1.7–5.7) | 0.874 | 8.6 (6.4–11.5) | 8.6 (5.6–12.7) | 0.981 |
Distribution of depression severity and depression symptoms in cases with 12-month MDD
Men | Women | |||||
---|---|---|---|---|---|---|
1997–1999 (n = 110) | 2009–2012 (n = 71) | p-value3 | 1997–1999 (n = 238) | 2009–2012 (n = 159) | p-value3 | |
Depression severity, % (95%-CI) | ||||||
Mild (5/9 symptoms) | 31.7 (22.3–42.9) | 27.1 (16.2–41.7) | 0.574 |
24.1 (18.3–30.9)
|
13.8 (8.0–22.7)
|
0.045
|
Moderate (6 + 7/9 symptoms) | 45.0 (35.2–55.1) | 43.0 (31.0–55.9) | 0.803 | 41.5 (34.2–49.2) | 47.2 (37.0–57.7) | 0.329 |
Severe (8 + 9/9 symptoms) | 23.3 (15.8–33.1) | 29.9 (19.0–43.7) | 0.373 | 34.5 (27.2–42.6) | 39.0 (28.2–51.1) | 0.466 |
Health-related correlates
Men | Women | |||||||
---|---|---|---|---|---|---|---|---|
With MDD | Without MDD | With MDD | Without MDD | |||||
1997–1999 (n = 110) | 2009–2012 (n = 71) | 1997–1999 (n = 1801) | 2009–2012 (n = 1451) | 1997–1999 (n = 238) | 2009–2012 (n = 159) | 1997–1999 (n = 2027) | 2009–2012 (n = 1584) | |
Fair/poor self-rated health, % (95%-CI) | 36.8 (26.7–48.3) | 37.1 (24.6–51.6) |
13.9 (12.0–16.1)
|
10.1 (8.3–12.3)
|
40.4 (32.7–48.5)
|
21.3 (13.9–31.2)
|
14.6 (12.7–16.6)
|
10.9 (9.2–13.0)
|
Health-related quality of life (4 weeks)3, mean (95%-CI) | ||||||||
Physical functioning | 50.3 (48.4–52.1) | 48.8 (46.0–51.6) |
52.9 (52.5–53.3)
|
53.6 (53.2–54.0)
| 47.8 (46.3–49.3) | 49.3 (46.9–51.7) |
51.6 (51.1–52.0)
|
52.5 (52.1–52.9)
|
Physical role functioning | 47.4 (44.8–50.0) | 43.1 (39.6–46.6) | 52.8 (52.3–53.2) | 52.2 (51.7–52.7) | 46.5 (44.7–48.2) | 46.6 (44.4–48.9) |
51.6 (51.2–52.1)
|
50.7 (50.2–51.2)
|
Bodily pain | 45.1 (42.6–47.5) | 43.4 (40.0–46.7) |
51.1 (50.4–51.7)
|
54.1 (53.4–54.8)
|
41.8 (39.8–43.8)
|
47.9 (45.3–50.6)
|
48.0 (47.4–48.6)
|
51.3 (50.6–52.0)
|
General health | 42.8 (41.0–44.6) | 42.2 (39.3–45.1) |
49.0 (48.5–49.4)
|
50.6 (50.0–51.2)
| 43.2 (41.4–44.9) | 45.4 (43.3–47.5) |
49.1 (48.6–49.7)
|
50.5 (50.1–51.0)
|
Vitality | 45.3 (43.2–47.4) | 43.1 (39.8–46.3) | 52.9 (52.4–53.3) | 53.1 (52.6–53.6) | 43.0 (41.7–44.3) | 43.7 (41.2–46.2) | 50.8 (50.3–51.3) | 51.2 (50.7–51.8) |
Social role functioning |
44.0 (41.7–46.3)
|
39.6 (36.0–43.2)
| 52.6 (52.2–53.0) | 52.4 (51.9–52.9) | 41.4 (39.4–43.4) | 41.6 (39.2–44.1) | 51.1 (50.6–51.6) | 50.9 (50.4–51.5) |
Emotional role functioning |
44.6 (41.5–47.7)
|
36.3 (32.4–40.1)
|
52.9 (52.5–53.2)
|
51.6 (51.1–52.1)
| 43.1 (40.9–45.3) | 40.4 (37.3–43.5) |
52.0 (51.6–52.5)
|
49.4 (48.7–50.0)
|
Mental health | 39.0 (36.9–41.1) | 37.0 (34.1–39.8) | 50.2 (49.8–50.7) | 50.8 (50.2–51.3) | 36.8 (35.0–38.6) | 38.7 (36.7–40.8) |
47.6 (47.1–48.2)
|
48.6 (48.0–49.2)
|
Physical component score | 49.2 (47.1–51.2) | 48.4 (45.3–51.5) |
51.8 (51.3–52.3)
|
53.4 (52.8–53.9)
|
47.6 (45.9–49.4)
|
51.4 (49.2–53.6)
|
50.6 (50.1–51.1)
|
52.3 (51.9–52.8)
|
Mental component score |
40.5 (38.0–42.9)
|
35.3 (32.0–38.5)
|
51.6 (51.2–52.0)
|
50.9 (50.4–51.5)
| 38.5 (36.5–40.4) | 37.2 (34.5–40.0) |
49.8 (49.3–50.4)
|
48.9 (48.3–49.5)
|
Any days with activity limitation (4 weeks), % (95%-CI) | ||||||||
due to mental health problems |
9.1 (4.9–16.5)
|
25.9 (14.8–41.3)
|
0.4 (0.2–0.7)
|
1.7 (1.0–3.0)
|
5.9 (3.1–10.8)
|
29.0 (19.3–41.0)
|
1.6 (1.0–2.6)
|
3.7 (2.6–5.2)
|
due to physical health problems | 21.0 (13.4–31.2) | 26.7 (16.3–40.5) | 14.0 (11.8–16.4) | 12.7 (10.6–15.2) | 20.0 (14.6–26.7) | 26.5 (17.8–37.6) | 14.6 (12.8–16.7) | 13.6 (11.5–16.0) |
Any sick days (12 month), % (95%-CI) | 69.3 (57.6–79.0) | 74.5 (59.6–85.2) |
49.9 (47.0–52.8)
|
59.5 (56.0–62.9)
| 68.1 (60.4–74.9) | 76.5 (65.6–84.7) |
55.4 (52.5–58.1)
|
63.8 (60.7–66.8)
|
No. of sick days if any4, mean (95%CI) | 62.8 (38.0–87.6) | 62.4 (24.9–100.0) | 25.0 (20.5–29.5) | 19.7 (16.3–23.0) | 39.6 (27.4–51.8) | 26.2 (16.6–35.9) | 19.6 (17.4–21.7) | 19.1 (15.1–23.1) |
Men | Women | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
With MDD | Without MDD | With MDD | Without MDD | ||||||||
Effect estimate (95%-CI) | p trend | Effect estimate (95%-CI) | p trend | p MDD × trend | Effect estimate (95%CI) | p trend | Effect estimate (95%-CI) | p trend | p MDD × trend | ||
Fair/poor self-rated health | OR | 1.0 (0.5–2.1) | 0.972 | 0.7 (0.5–0.9) |
0.006
| 0.370 | 0.4 (0.2–0.7) |
0.001
| 0.7 (0.6–0.9) |
0.007
|
0.043
|
Health-related quality of life (4 weeks) | |||||||||||
Physical functioning | β | −1.5 (− 4.8–1.9) | 0.391 | 0.7 (0.1–1.3) |
0.021
| 0.214 | 1.5 (−1.1–4.1) | 0.252 | 0.9 (0.4–1.5) |
0.001
| 0.668 |
Physical role functioning | β | −4.3 (− 8.8–0.2) | 0.061 | −0.6 (−1.3–0.1) | 0.098 | 0.116 | 0.2 (− 2.7–3.0) | 0.897 | −1.0 (− 1.6−−0.3) |
0.005
| 0.433 |
Bodily pain | β | −1.7 (− 5.8–2.4) | 0.413 | 3.0 (2.1–4.0) |
< 0.001
|
0.030
| 6.1 (3.0–9.2) |
< 0.001
| 3.3 (2.5–4.1) |
< 0.001
| 0.077 |
General health | β | −0.6 (−4.1–2.9) | 0.727 | 1.6 (0.9–2.3) |
< 0.001
| 0.230 | 2.2 (−0.4–4.9) | 0.097 | 1.4 (0.7–2.1) |
< 0.001
| 0.534 |
Vitality | β | − 2.2 (− 6.4–1.9) | 0.281 | 0.2 (−0.4–0.9) | 0.448 | 0.237 | 0.7 (− 2.1–3.5) | 0.612 | 0.4 (−0.2–1.1) | 0.180 | 0.851 |
Social role functioning | β | −4.4 (− 8.9–0.0) |
0.048
| −0.2 (−0.8–0.4) | 0.529 | 0.063 | 0.2 (−2.7–3.2) | 0.870 | −0.2 (− 0.9–0.6) | 0.654 | 0.790 |
Emotional role functioning | β | −8.3 (−13.3−−3.3) |
0.001
| −1.3 (−1.9−−0.7) |
< 0.001
|
0.006
| −2.7 (− 6.7–1.2) | 0.177 | −2.6 (−3.4−−1.9) |
< 0.001
| 0.966 |
Mental health | β | −2.0 (− 5.7–1.6) | 0.273 | 0.5 (−0.1–1.2) | 0.118 | 0.171 | 2.0 (−0.6–4.5) | 0.131 | 1.0 (0.2–1.7) |
0.012
| 0.482 |
Physical component score | β | −0.8 (−4.5–3.0) | 0.694 | 1.6 (0.8–2.3) |
< 0.001
| 0.248 | 3.8 (1.2–6.3) |
0.004
| 1.8 (1.1–2.4) |
< 0.001
| 0.113 |
Mental component score | β | −5.2 (−9.4−−1.1) |
0.014
| −0.7 (−1.3–0.0) |
0.040
|
0.033
| −1.2 (−4.6–2.2) | 0.477 | −0.9 (−1.8−−0.1) |
0.023
| 0.874 |
Any days with activity limitation (4 weeks) | |||||||||||
due to mental health problems | OR | 3.5 (1.4–9.0) |
0.010
| 4.9 (2.0–11.7) |
< 0.001
| 0.607 | 6.5 (2.8–15.4) |
< 0.001
| 2.3 (1.3–4.2) |
0.007
| 0.056 |
due to physical health problems | OR | 1.4 (0.6–3.3) | 0.482 | 0.9 (0.7–1.2) | 0.403 | 0.363 | 1.5 (0.8–2.7) | 0.251 | 0.9 (0.7–1.2) | 0.494 | 0.196 |
Any sick days (12 month) | OR | 1.3 (0.5–3.1) | 0.569 | 1.5 (1.2–1.8) |
< 0.001
| 0.787 | 1.5 (0.8–2.9) | 0.198 | 1.4 (1.2–1.7) |
< 0.001
| 0.846 |
No. of sick days if any | IRR | 1.0 (0.5–2.1) | 0.988 | 0.8 (0.6–1.0) | 0.058 | 0.542 | 0.7 (0.4–1.1) | 0.089 | 1.0 (0.8–1.2) | 0.848 | 0.150 |