Epidemiology of depression

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The epidemiology of depression has been studied across the world. Depression is a major cause of morbidity and mortality worldwide, as the epidemiology has shown.[1] Lifetime prevalence estimates vary widely, from 3% in Japan to 17% in India. Epidemiological data shows higher rates of depression in the Middle East, North Africa, South Asia and the United States than in other regions and countries.[2] For most countries among the 10 studied, the number of people who experience depression during their lifetimes falls within an 8–12% range.[3][4]

In North America, the probability of having a major depressive episode within any year-long period is 3–5% for males and 8–10% for females.[5][6]

Demographic dynamics

Population studies have consistently shown major depression to be about twice as common in women as in men, although it is not yet clear why this is so.[7] The relative increase in occurrence is related to pubertal development rather than chronological age, reaches adult ratios between the ages of 15 and 18, and appears associated with psychosocial more than hormonal factors.[7]

People are most likely to suffer their first depressive episode between the ages of 30 and 40, and there is a second, smaller peak of incidence between ages 50 and 60.[8] The risk of major depression is increased with neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis and during the first year after childbirth.[9] The risk of major depression has also been related to environmental stressors faced by population groups such as war combatants or physicians in training.[10][11]

It is also more common after cardiovascular illnesses, and is related to a poor outcome of cardiovascular diseases.[12][13] Studies conflict on the prevalence of depression in the elderly, but most data suggest there is a reduction in this age group.[14] Depressive disorders are most common in urban than in rural population and, in general, the prevalence is higher in groups with adverse socio-economic factors (for example in homeless people).[15]

Data on the relative prevalence of major depression among different ethnic groups have reached no clear consensus. However, the only known study to have covered dysthymia in the US specifically found it to be more common in African and Mexican Americans than in European Americans.[16]

Projections indicate that depression may be the second leading cause of life lost after heart disease by 2020.[17]

In 2016, a study, published by JAMA Psychiatry, and written by Charlotte Wessel Skovlund, found an association between hormonal contraception and depression.[18]

By country and category

Age-standardised disability-adjusted life year (DALY) rates per 10,000 inhabitants in 2017.[19]

Category 1990 2017 Absolute change Relative change
Afghanistan 439.81 443.57 +3.75 <1%
Albania 306.48 308.44 +1.96 <1%
Algeria 454.02 455.36 +1.34 <1%
American Samoa 299.00 301.44 +2.43 <1%
Andean Latin America 395.14 395.61 +0.47 <1%
Andorra 462.69 466.65 +3.96 <1%
Angola 300.38 307.07 +6.68 +2%
Antigua and Barbuda 423.69 423.07 –0.63 >–1%
Argentina 554.67 555.27 +0.60 <1%
Armenia 235.57 235.64 +0.07 <1%
Australasia 588.29 588.66 +0.36 <1%
Australia 564.71 564.13 –0.58 >–1%
Austria 473.10 470.30 –2.81 >–1%
Azerbaijan 237.12 235.03 –2.09 >–1%
Bahamas 426.25 425.91 –0.34 >–1%
Bahrain 428.36 426.75 –1.61 >–1%
Bangladesh 390.09 399.43 +9.34 +2%
Barbados 427.13 425.42 –1.71 >–1%
Belarus 262.09 261.92 –0.16 >–1%
Belgium 454.81 453.91 –0.90 >–1%
Belize 417.94 421.10 +3.16 <1%
Benin 270.23 272.67 +2.43 <1%
Bermuda 425.79 426.62 +0.83 <1%
Bhutan 348.85 351.02 +2.17 <1%
Bolivia 393.70 393.43 –0.27 >–1%
Bosnia and Herzegovina 308.44 307.51 –0.92 >–1%
Botswana 321.91 319.57 –2.34 >–1%
Brazil 513.45 554.75 +41.30 +8%
Brunei 315.25 318.63 +3.37 +1%
Bulgaria 325.36 325.40 +0.04 <1%
Burkina Faso 269.71 273.79 +4.07 +2%
Burundi 340.21 335.02 –5.19 –2%
Cambodia 306.36 306.09 –0.26 >–1%
Cameroon 269.81 271.78 +1.97 <1%
Canada 484.22 450.76 –33.46 –7%
Cape Verde 278.10 274.58 –3.52 –1%
Caribbean 422.38 421.72 –0.66 >–1%
Central African Republic 300.76 303.45 +2.69 <1%
Central Asia 235.74 234.85 –0.89 >–1%
Central Europe 307.09 306.99 –0.09 >–1%
Central Europe, Eastern Europe, and Central Asia 271.76 268.25 –3.51 –1%
Central Latin America 264.02 270.29 +6.27 +2%
Central Sub-Saharan Africa 300.88 304.43 +3.55 +1%
Chad 270.61 269.81 -0.80 >–1%
Chile 553.66 550.58 –3.08 >–1%
China 289.57 275.39 –14.18 –5%
Colombia 244.81 230.00 –14.81 –6%
Comoros 334.19 339.17 +4.98 +1%
Congo 303.07 304.40 +1.33 <1%
Costa Rica 264.62 267.24 +2.62 <1%
Côte d'Ivoire 266.99 269.37 +2.38 <1%
Croatia 310.58 309.13 –1.45 >–1%
Cuba 421.37 421.70 +0.33 <1%
Cyprus 470.31 472.29 +1.98 <1%
Czechia 309.12 307.16 –1.96 >–1%
Democratic Republic of Congo 300.71 303.61 +2.90 <1%
Denmark 470.42 469.49 –0.93 >–1%
Djibouti 327.85 330.88 +3.03 <1%
Dominica 422.36 418.16 –4.20 >–1%
Dominican Republic 424.23 420.58 –3.65 >–1%
East Asia 290.12 276.32 –13.80 –5%
Eastern Europe 262.88 262.56 –0.32 >–1%
Eastern Sub-Saharan Africa 336.34 340.89 +4.55 +1%
Ecuador 395.69 396.44 +0.75 <1%
Egypt 398.29 398.86 +0.57 <1%
El Salvador 266.25 270.06 +3.81 +1%
England 395.05 395.14 +0.09 <1%
Equatorial Guinea 304.76 303.81 -0.94 >–1%
Eritrea 331.15 339.69 +8.54 +3%
Estonia 261.91 261.21 -0.70 >–1%
Eswatini 322.64 318.73 –3.90 –1%
Ethiopia 347.39 349.31 +1.92 <1%
Fiji 299.92 300.46 +0.54 <1%
Finland 333.44 329.68 –3.76 –1%
France 576.00 576.03 +0.03 <1%
Gabon 303.27 306.57 +3.31 +1%
Gambia 268.55 271.49 +2.94 +1%
Georgia 238.24 235.38 –2.87 –1%
Germany 564.54 565.03 +0.48 <1%
Ghana 272.17 274.68 +2.51 <1%
Greece 512.06 511.19 –0.87 >–1%
Greenland 492.10 500.98 +8.89 +2%
Grenada 423.74 417.51 –6.23 –1%
Guam 299.44 301.30 +1.86 <1%
Guatemala 263.12 267.56 +4.45 +2%
Guinea 271.79 273.08 +1.29 <1%
Guinea-Bissau 271.17 272.76 +1.59 <1%
Guyana 418.26 420.11 +1.84 <1%
Haiti 417.74 420.25 +2.50 <1%
High SDI 462.62 463.66 +1.04 <1%
High-income 489.63 494.52 +4.89 <1%
High-income Asia Pacific 318.28 318.18 –0.10 >–1%
High-middle SDI 329.26 342.11 +12.86 +4%
Honduras 264.60 266.37 +1.77 <1%
Hungary 308.84 309.31 +0.47 <1%
Iceland 469.33 469.26 –0.06 >–1%
India 309.28 306.76 –2.53 >–1%
Indonesia 304.31 304.18 –0.12 >–1%
Iran 689.12 692.26 –6.25 >–1%
Iraq 427.22 430.09 +2.87 <1%
Ireland 506.29 511.29 +5.00 <1%
Israel 274.39 274.00 –0.40 >–1%
Italy 512.79 499.21 –13.58 –3%
Jamaica 424.62 422.32 –2.30 >–1%
Japan 257.27 224.62 –12.69 >–1%
Jordan 447.61 445.91 –1.70 >–1%
Kazakhstan 235.88 236.01 +0.13 <1%
Kenya 337.41 339.52 +2.10 <1%
Kiribati 302.20 303.25 +1.04 <1%
Kuwait 430.22 444.44 +14.22 +3%
Kyrgyzstan 235.31 235.09 –0.22 >–1%
Laos 388.45 390.62 +2.17 <1%
Latin America and Caribbean 393.06 405.65 +12.59 +3%
Latvia 261.95 261.48 –0.46 >–1%
Lebanon 545.72 547.07 +1.35 <1%
Lesotho 320.94 318.40 –2.54 >–1%
Liberia 266.73 267.44 +0.71 <1%
Libya 443.86 449.94 +6.08 +1%
Lithuania 261.63 261.43 –0.19 >–1%
Low SDI 326.04 329.76 +3.72 +1%
Low-middle SDI 332.91 337.68 +4.77 +1%
Luxembourg 468.43 467.04 –1.39 >–1%
Madagascar 332.44 336.98 +4.53 +1%
Malawi 335.11 341.69 +6.58 +2%
Malaysia 392.10 389.83 –2.26 >–1%
Maldives 295.24 291.29 –3.96 –1%
Mali 268.90 270.70 +1.80 <1%
Malta 472.67 468.46 –4.21 >–1%
Marshall Islands 299.32 299.31 –0.02 >–1%
Mauritania 272.46 273.97 +1.51 <1%
Mauritius 303.11 302.78 –0.33 >–1%
Mexico 271.36 289.05 +17.69 +7%
Micronesia (country) 299.20 299.84 +0.64 <1%
Middle SDI 306.44 306.98 +0.54 <1%
Moldova 260.72 261.03 +0.31 <1%
Mongolia 233.62 234.85 +1.23 <1%
Montenegro 309.18 308.71 –0.47 >–1%
Morocco 452.71 453.82 +1.11 <1%
Mozambique 336.20 341.61 +5.41 +2%
Myanmar 300.93 307.06 +6.13 +2%
Namibia 320.84 322.18 +1.34 <1%
Nepal 348.75 359.13 +10.38 +3%
Netherlands 579.45 578.84 –0.62 >–1%
New Zealand 705.21 722.98 +17.77 +3%
Nicaragua 264.58 265.73 +1.15 <1%
Niger 271.34 272.82 +1.47 <1%
Nigeria 268.96 272.57 +3.61 +1%
North Africa and Middle East 448.40 450.80 +2.39 <1%
North America 561.85 561.25 –0.60 >–1%
North Korea 304.06 297.84 –6.22 –2%
North Macedonia 308.26 307.40 –0.86 >–1%
Northern Ireland 651.12 660.19 +9.07 +1%
Northern Mariana Islands 296.39 300.91 +4.52 +2%
Norway 673.49 665.89 –7.59 –1%
Oceania 296.33 297.51 +1.18 <1%
Oman 421.68 413.70 –7.97 –2%
Pakistan 349.19 353.29 +4.10 +1%
Palestine 455.01 451.42 –3.59 >–1%
Panama 263.33 264.25 +0.92 <1%
Papua New Guinea 294.77 296.24 +1.48 <1%
Paraguay 553.15 552.96 –0.19 >–1%
Peru 395.29 395.88 +0.59 <1%
Philippines 302.25 302.49 +0.24 <1%
Poland 309.40 309.37 –0.04 >–1%
Portugal 472.59 473.61 +1.01 <1%
Puerto Rico 427.30 425.85 –1.45 >–1%
Qatar 403.81 391.06 –12.75 –3%
Romania 292.12 292.61 +0.49 <1%
Russia 262.99 262.58 –0.42 >–1%
Rwanda 338.57 343.75 +5.18 +2%
Saint Lucia 424.55 421.42 –3.13 >–1%
Saint Vincent and the Grenadines 421.10 417.18 –3.92 >–1%
Samoa 299.55 300.51 +0.96 <1%
São Tomé and Príncipe 273.98 273.61 –0.37 >–1%
Saudi Arabia 430.80 435.29 +4.49 +1%
Scotland 421.09 419.01 –2.08 >–1%
Senegal 271.34 271.99 +0.66 <1%
Serbia 308.40 307.93 –0.47 >–1%
Seychelles 305.21 300.90 –4.30 –1%
Sierra Leone 271.01 270.96 –0.05 >–1%
Singapore 319.22 326.20 +6.98 +2%
Slovakia 309.64 309.22 –0.42 >–1%
Slovenia 309.55 306.52 –3.03 >-1%
Solomon Islands 296.00 298.91 +2.91 <1%
Somalia 327.47 333.31 +5.84 +2%
South Africa 367.94 365.43 –2.51 >–1%
South Asia 320.86 320.95 +0.09 <1%
South Korea 338.46 335.96 –2.50 >–1%
South Sudan 317.40 329.08 +11.67 +4%
Southeast Asia 291.86 292.91 +1.05 <1%
Southeast Asia, East Asia, and Oceania 289.93 280.40 –9.53 –3%
Southern Latin America 554.25 554.08 –0.18 >–1%
Southern Sub-Saharan Africa 349.41 348.08 –1.33 >–1%
Spain 444.92 463.69 +18.77 +4%
Sri Lanka 301.85 307.85 +6.00 +2%
Sub-Saharan Africa 307.47 308.98 +1.51 <1%
Sudan 452.15 452.80 +0.65 <1%
Suriname 419.61 421.18 +1.57 <1%
Sweden 469.30 467.41 –1.89 >–1%
Switzerland 468.85 468.55 –0.30 >–1%
Syria 452.10 453.39 +1.29 <1%
Taiwan 307.25 306.89 –0.36 >–1%
Tajikistan 234.35 232.74 –1.62 >–1%
Tanzania 335.95 341.24 +5.30 +2%
Thailand 305.63 306.91 +1.28 <1%
Timor 295.90 300.52 +4.63 +2%
Togo 272.10 274.16 +2.05 <1%
Tonga 302.76 302.51 –0.25 >–1%
Trinidad and Tobago 419.97 419.20 –0.77 >–1%
Tropical Latin America 514.41 554.73 +40.32 +8%
Tunisia 455.67 459.67 +4.00 <1%
Turkey 342.96 352.71 +9.74 +3%
Turkmenistan 236.15 233.30 –2.85 –1%
Uganda 317.76 330.35 +12.59 +4%
Ukraine 263.10 262.92 –0.18 >–1%
United Arab Emirates 390.77 386.30 –4.46 –1%
United Kingdom 406.06 406.09 +0.03 <1%
United States 570.31 573.38 +3.06 <1%
United States Virgin Islands 428.12 428.10 –0.02 >–1%
Uruguay 555.13 557.10 +1.96 <1%
Uzbekistan 234.56 234.50 –0.05 >–1%
Vanuatu 295.97 298.94 +2.97 +1%
Venezuela 265.18 264.86 –0.32 >–1%
Vietnam 192.79 192.17 –0.62 >–1%
Wales 423.11 421.79 –1.32 >–1%
Western Europe 502.89 499.26 –3.63 >–1%
Western Sub-Saharan Africa 269.65 272.36 +2.70 +1%
World 348.53 345.69 –2.84 >–1%
Yemen 442.49 446.34 +3.85 <1%
Zambia 334.01 337.31 +3.30 <1%
Zimbabwe 286.38 286.72 +0.34 <1%

See also

References

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