Introduction
Methods
Study design and data collection
Depression, comorbidities and antidepressive treatment
Data analysis
Results
Trends in age-standardized prevalence and incidence of depression (2000-2019)
Summary | Trend 1 | Trend 2 | Trend 3 | ||||||
---|---|---|---|---|---|---|---|---|---|
Year 2000 | Year 2019 | AAPC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) | |
Prevalence (/100) | |||||||||
Total | 6.73 | 9.20 | 1.6 (1.2;1.9) | 2000-2019 | 1.6 (1.2;1.9) | ||||
Women | 9.10 | 11.63 | 1.3 (1.0;1.6) | 2000-2019 | 1.3 (1.0;1.6) | ||||
Men | 4.05 | 6.40 | 2.0 (1.6;2.5) | 2000-2019 | 2.0 (1.6;2.5) | ||||
15-29 | 1.80 | 3.72 | 3.6 (2.7;4.6) | 2000-2004 | 6.4 (2.4;10.7) | 2004-2013 | 0.2 (-0.9;1.3) | 2013-2019 | 7.2 (5.7;8.6) |
30-44 | 6.30 | 8.77 | 1.4 (1.1;1.8) | 2000-2019 | 1.4 (1.1;1.8) | ||||
45-59 | 9.90 | 12.44 | 1.1 (0.5;1.7) | 2000-2017 | 1.7 (1.4;2.0) | 2017-2019 | -3.8 (-9.3;2.1) | ||
60-74 | 8.86 | 12.04 | 1.5 (0.6;2.3) | 2000-2016 | 2.4 (1.9;3.0) | 2016-2019 | -3.6 (-8.3;1.4) | ||
75+ | 8.17 | 10.40 | 1.3 (1.0:1.6) | 2000-2019 | 1.3 (1.0:1.6) | ||||
Incidence (/1000) | |||||||||
Total | 9.42 | 13.64 | 1.9 (0.4;3.3) | 2000-2015 | -2.3 (-3.3;-1.3) | 2015-2019 | 19.1 (11.8;26.9) | ||
Women | 11.62 | 16.68 | 1.7 (0.0;3.5) | 2000-2015 | -2.5 (-3.7;-1.2) | 2015-2019 | 19.2 (10.3;28.7) | ||
Men | 7.14 | 10.27 | 1.6 (0.4;2.9) | 2000-2014 | -2.5 (-3.5;-1.5) | 2014-2019 | 14.2 (9.6;19.0) | ||
15-29 | 7.37 | 13.62 | 3.3 (1.1;5.5) | 2000-2015 | -1.0 (-2.5;0.6) | 2015-2019 | 20.9 (10.4;32.4) | ||
30-44 | 10.66 | 16.66 | 1.7 (0.0;3.5) | 2000-2015 | -1.8 (-3.0;-0.6) | 2015-2019 | 16.2 (7.8;25.3) | ||
45-59 | 11.94 | 14.89 | 1.4 (-0.5;3.3) | 2000-2015 | -2.7 (-3.9;-1.4) | 2015-2019 | 18.1 (8.9;28.1) | ||
60-74 | 7.67 | 9.29 | 0.8 (-1.7;3.2) | 2000-2015 | -4.5 (-6.0;-2.9) | 2015-2019 | 23.0 (10.2;37.2) | ||
75+ | 7.72 | 9.80 | 1.9 (-1.1;4.9) | 2000-2014 | -3.7 (-6.3;-1.1) | 2014-2019 | 19.5 (8.6;31.6) |
Trends in comorbidities at diagnosis (2000-2019)
Variables | 2000-2003 | 2004-2007 | 2008-2011 | 2012-2016 | 2017-2019 | Trend test | ||
---|---|---|---|---|---|---|---|---|
STUDY POPULATION | ||||||||
Patients with depression (n) | 3268 | 3650 | 3535 | 3545 | 5732 | 0 | ||
Mean age (standard deviation) | 45.2(17) | 45.4(17.1) | 44.9(17) | 44.3(17.5) | 44.5(18.6) | 1 | ||
Number of women (%) | 2054(62.9) | 2392(65.5) | 2244(63.5) | 2189(61.7) | 3720(64.9) | 0.6175 | ||
PREVALENCE OF COMORBIDITIES, n (%) | ICPC code | |||||||
Mean chronic disease count per patient (SD) | 1.2(1.6) | 1.3(1.8) | 1.5(2) | 1.6(2) | 1.8(2.1) | 0.0002 | ||
Anxiety disorder | P74 | 15(0.5) | 26(0.7) | 28(0.8) | 31(0.9) | 167(2.9) | <0.0001 | |
Alcohol abuse | P15-16 | 60(1.8) | 98(2.7) | 98(2.8) | 163(4.6) | 208(3.6) | <0.0001 | |
Dementia | P70 | 15(0.5) | 15(0.4) | 30(0.8) | 41(1.2) | 63(1.1) | <0.0001 | |
Schizophrenia | P72 | 13(0.4) | 15(0.4) | 13(0.4) | 16(0.5) | 28(0.5) | 0.4464 | |
Suicide/suicide attempt | P77 | 3(0.1) | 6(0.2) | 7(0.2) | 9(0.3) | 34(0.6) | <0.0001 | |
Phobia/compulsive disorder | P79 | 29(0.9) | 25(0.7) | 23(0.7) | 46(1.3) | 76(1.3) | 0.0012 | |
Personality disorder | P80 | 10(0.3) | 26(0.7) | 30(0.8) | 52(1.5) | 194(3.4) | <0.0001 | |
Anorexia nervosa/bulimia | P86 | 5(0.2) | 1(0) | 3(0.1) | 5(0.1) | 12(0.2) | 0 | |
Substance abuse | P18-19 | 7(0.2) | 10(0.3) | 17(0.5) | 16(0.5) | 65(1.1) | <0.0001 | |
Atrial fibrillation/flutter | K78 | 47(1.4) | 50(1.4) | 54(1.5) | 69(1.9) | 128(2.2) | 0.0004 | |
Hypertension | K86-87 | 392(12) | 486(13.3) | 492(13.9) | 429(12.1) | 836(14.6) | 0.0074 | |
Heart failure | K77 | 23(0.7) | 35(1) | 30(0.8) | 32(0.9) | 46(0.8) | 0.8971 | |
Atherosclerosis | K92 | 59(1.8) | 82(2.2) | 62(1.8) | 61(1.7) | 88(1.5) | 0.0707 | |
Ischemic heart disease | K74-75-76 | 95(2.9) | 126(3.5) | 98(2.8) | 103(2.9) | 140(2.4) | 0.039 | |
Diabetes Mellitus | T89-90 | 114(3.5) | 167(4.6) | 231(6.5) | 320(9) | 382(6.7) | <0.0001 | |
Hypothyroidism | T86 | 50(1.5) | 47(1.3) | 49(1.4) | 57(1.6) | 162(2.8) | <0.0001 | |
Hyperthyroidism | T85 | 6(0.2) | 12(0.3) | 6(0.2) | 7(0.2) | 31(0.5) | 0.0093 | |
Irritable bowel syndrome | D01-D93 | 296(9.1) | 363(9.9) | 378(10.7) | 363(10.2) | 549(9.6) | 0.6288 | |
Asthma | R96 | 194(5.9) | 277(7.6) | 321(9.1) | 348(9.8) | 603(10.5) | <0.0001 | |
COPD | R95 | 83(2.5) | 110(3) | 104(2.9) | 94(2.7) | 214(3.7) | 0.0055 | |
Osteoarthritis | L89-90-91 | 314(9.6) | 384(10.5) | 434(12.3) | 356(10) | 528(9.2) | 0.1349 | |
Cerebrovascular disease | K90-91 | 60(1.8) | 68(1.9) | 72(2) | 78(2.2) | 153(2.7) | 0.0025 | |
Malignancy | A79-Y78-N74-Y77-U76-T71-D76-D74-U77-U75-D75-R84-B74-S77-R85-D77-X76-W72-X75-X77 | 97(3) | 139(3.8) | 194(5.5) | 259(7.3) | 696(12.1) | <0.0001 | |
Chronic Kidney Disease | 44(1.3) | 35(1) | 36(1) | 36(1) | 66(1.2) | 0.7067 |
Trends in antidepressant prescriptions (2000-2019)
SUMMARY | Trend 1 | Trend 2 | Trend 3 | ||||||
---|---|---|---|---|---|---|---|---|---|
Medication (%) | Year 2000 | Year 2019 | AAPC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) | Years | APC (95% CI) |
Total | 26.42 | 40.16 | 2.4 (1.0;3.7) | 2000-2002 | 7.1 (-5.4;21.3) | 2002-2016 | 0.2 (-0.3;0.7) | 2016-2019 | 9.6 (5.7;13.6) |
Women | 26.75 | 41.92 | 2.4(1.3;3.6) | 2000-2002 | 8.3 (-2.6;20.5) | 2002-2016 | 0.4 (-0.1;0.8) | 2016-2019 | 8.6 (5.2;12) |
Men | 25.58 | 36.51 | 1.8 (0.9;2.7) | 2000-2016 | 0.1 (-0.5;0.6) | 2016-2019 | 11.6 (6.0;17.5) | ||
ANTIDEPRESSANTS | |||||||||
SSRI | 15.89 | 22.28 | 1.8 (0.4;3.1) | 2000-2004 | 5.0 (-0.5;10.8) | 2004-2014 | -2.4 (-3.6;-1.2) | 2014-2019 | 8.0 (5.3;10.7) |
SNRI | 2.87 | 9.95 | 6.1 (4.6;7.6) | 2000-2010 | 9.1 (7.4;10.8) | 2010-2016 | -0.4 (-3.4;2.7) | 2016-2019 | 9.7 (3.8; 16.1) |
TCA | 6.09 | 5.07 | -0.7 (-1.2;-0.1) | 2000-2010 | -2.0 (-2.8;-1.1) | 2010-2019 | 0.7 (0.0;1.5) | ||
Neuromodulators | 5.62 | 11.65 | 3.9 (2.2;5.5) | 2000-2002 | 11.9 (-3.7;30.2) | 2002-2016 | 1.5 (1.0;2.1) | 2016-2019 | 10.0 (5.8;14.3) |
MAOI | 0.29 | 0.06 | -6.1 (-10.1;-1.9) | 2000-2005 | -22.8 (-33.6;-10.1) | 2005-2019 | 0,7 (-2.8;4.3) | ||
Bupropion | 0.36 | 2.19 | 7.4(5.4;9.5) | 2000-2019 | 7.4(5.4;9.5) | ||||
OTHER | |||||||||
Antipsychotics | 7.28 | 8.29 | 0.3 (-0.2;0.8) | 2000-2019 | 0.3 (-0.2;0.8) | ||||
Anxiolytics | 19.52 | 18.09 | -0.7 (-1.1;-0.2) | 2000-2013 | -1.2(-1.7;-0.8) | 2013-2019 | 0.5 (-0.7;-1.6) | ||
Hypnotics and sedatives | 11.27 | 14.77 | 1.3 (0.8;1.7) | 2000-2009 | 2.0 (1.5;2.5) | 2009-2017 | -0.1 (-0.7;0.5) | 2017-2019 | 3.5 (0.3;6.8) |
Year | One antidepressant prescription (%) | Two or more prescriptions (%) |
---|---|---|
2000 | 8.68 | 17.77 |
2001 | 8.39 | 19.97 |
2002 | 8.62 | 21.31 |
2003 | 8.15 | 22.04 |
2004 | 7.68 | 24.29 |
2005 | 7.34 | 23.75 |
2006 | 6.6 | 23.46 |
2007 | 6.77 | 23.95 |
2008 | 6.28 | 24.23 |
2009 | 6.44 | 23.99 |
2010 | 6.94 | 23.92 |
2011 | 6.59 | 24.31 |
2012 | 6.31 | 24.16 |
2013 | 6.28 | 24.06 |
2014 | 6.78 | 24.07 |
2015 | 6.5 | 25.21 |
2016 | 6.74 | 24.87 |
2017 | 6.39 | 20.48 |
2018 | 2.4 | 36.91 |
2019 | 2.83 | 37.33 |