Prevalence of Major and Non-major Depressive Disorders Among Women Veteran Clinic Users with Cardiovascular Conditions

Background: Although non-major depression is associated with adverse health outcomes, most of the research has focused on only major depression. Studies of individuals with non-major depression are needed because of the excess costs associated with non-major depression and the higher likelihood of those with non-major having a first lifetime episode of major depression.

Objective: To estimate the prevalence of major and non-major depression in a cohort of women with cardiovascular conditions and examine the predictors of major and non-major depression. Methods: Cross-sectional analysis of 158,252 women veteran clinic users with diabetes, hypertension, and heart disease derived from the 2002 veteran Health Administration administrative data and Medicare claims files. ICD-9-CM codes were used to identify cardiovascular conditions and depressive disorders: Major depressive disorder (MDD)- 296.2 and 296.3; Non-major depression included "depression not elsewhere classified (DNEC)" -311 and other depression-298.0, 300.4, 309.0, 309.1.

Results: Of the 30,136 (19%) women with depressive disorders, 54% were diagnosed with DNEC and 10% had other depression and 35% had MDD. Non-major depressive disorders were more likely among older, women veterans with service-connected disability. Non-major depression was less likely among those with Medicare enrollment and other physical and psychiatric disorders.

Conclusions: Non-major depression is highly prevalent among women with cardiovascular conditions. Because non-major depression is a major risk factor for major depressive disorders, patients with non-major depression need to be monitored for prevention and treatment.