The epidemiology of major depressive disorder and subthreshold depression in Izmir, Turkey: Prevalence, socioeconomic differences, impairment and help-seeking

PubMed ID: 25933098Background Subclinical and clinical depression is common, widely distributed in the general population, and usually associated with role impairment and help-seeking. Reliable information at the population level is needed to estimate the disease burden of depression and associated care needs in Turkey. Method The cross-sectional study aimed to assess the prevalence of subthreshold (SubD) and clinical major depressive disorder (MDD) in Izmir, Turkey. In the 5242 eligible households, a total of 4011 individuals were successfully interviewed, yielding a response rate of 76.5%. Prevalence estimates of MDD and SubD depression were formed by using the responses to the questions of the CIDI section E. Short Form 36 (SF-36) to assess health status and functional impairments in eight scaled scores during the last four weeks. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, as well as prescribed medicines and any hospitalization. Results The one year prevalence estimate for CIDI/DSM IV MDD was 8.2% (95% CI, 7.4-9.1). Less educated, low income, uninsured, low SES, unemployed/disabled and housewives, slum area residents had higher one year MDD prevalence. Determined prevalence of help seeking from mental health services of SubD and MDD cases were 23.6%, 30.6% respectively. Only 24.8% of clinically depressive patients received minimally adequate treatment. Limitations Cross sectional design. Conclusion Higher MDD prevalence correlates with younger ages, female gender, unemployment, less education, lower monthly income, lower SES and uninsurance. Help seeking from mental health services were low. There are treatment gap and impairment in depressive group. © 2015 Elsevier B.V.1001, 107S053, 112S476 1001, 107S053, 112S476This work is part of the TürkSch project, funded by the Scientific and Technological Council of Turkey 1001 programme, project numbers 107S053 and 112S476. -- This work is part of the TürkSch project, funded by the Scientific and Technological Council of Turkey 1001 programme , project no: 107S053 and 112S476 . The authors wish to acknowledge Prof. Dr. Ferda Özkınay and Ass. Prod. Dr. Hüseyin Onay for providing genetic data (stages III and IV of the TürkSch), senior colleagues who participated in the formal training of lay interviewers, field workers, and all the TürkSch respondents who kindly participated. The authors also thank to Scientific and Technological Council of Turkey for financial support to TürkSch research project. -