291953
Multi-country analysis of the characteristics associated with undiagnosed depression
Tuesday, November 5, 2013
Naira Tahir, MPH,
Department of Public Health Science, University of Rochester School of Medicine and Dentistry, Rochester, NY
Edwin Vanwijngaarden, Ph.D.,
Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
Ann M. Dozier, PhD, RN,
Public Health Sciences/Social and Behavioral Sciences, University of Rochester, Rochester, NY
Background: Multiple factors contribute to depression symptoms and receiving diagnosis including gender, age, culture, religion, health infrastructure, and country development amongst others. Few studies have explored this phenomenon worldwide. Methods: 2003 WHO World Health Survey data was linked to 2001-03 World Bank Indicators, CIA Fact book and WHO data. Bivariate analyses and logistic regression assessed characteristics associated with depression symptoms and diagnosis. Results: A disparity exists between reported symptoms of depression (28.6%) and receiving a diagnosis (8.6%). Women, those > 30 years, and those unemployed had higher symptom estimates including individuals from countries pre-dominantly Hindu versus Christian (OR: 5.8; 95% CI 4.0-8.4) Southeast Asia, America's, and Western Pacific regions when compared to Africa (ORs ranging from 1.5-1.8), and higher income nations. (OR: 1.8; 95% CI 1.2-2.7) Lower estimates were found in countries allocating a small proportion of the total GDP towards health (<6%) and mental health (<1%). (ORs ranging from 0.5-0.7) Amongst screen positives, non-diagnosis was higher amongst unemployed individuals, > 30 years, and rural residents, publically financed mental health systems, countries allocating a large proportion of the total GDP to healthcare (> 6%) and mental health care (> 1%), predominantly Hindu versus Christian countries (OR: 6.3; CI: 4.2-9.4) and countries with < 1:1 ratio of male to female literacy (ORs ranging from 1.7-1.8) and a lower risk amongst lower-middle income. (OR: 0.5; CI: 0.3-0.8) Implications: These results provide an understanding of characteristics associated with prevalence and diagnosis of depression and can inform evolving mental health systems and policies worldwide.
Learning Areas:
Chronic disease management and prevention
Public health or related public policy
Public health or related research
Social and behavioral sciences
Learning Objectives:
Identify the individual and country characteristics contributing to the gap between symptoms of depression and diagnosis of the disorder.
Differentiate between the characteristics associated with symptoms of depression and receiving a diagnosis for the disorder between developed and developing countries.
Keyword(s): International Public Health, International Systems
Presenting author's disclosure statement:Qualified on the content I am responsible for because: Aside from the current research project, I have co-authored two additional manuscripts focused on FASD which have been submitted to publication. Additionally, I have independently conducted analysis and reports for community health organizations. Among my interests are international health, health policy and planning, and comparitive effectiveness.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
