Epidemiology of Depression

Epidemiological evidence shows that major depressive disorder (MDD) is a commonly occurring, seriously impairing, and often undertreated disorder. MDD occurs in the context of a very high prevalence of depressed mood and a high prevalence of subsyndromal depressive episodes. MDD is often recurrent and is typically comorbid with other mental disorders that are usually temporally primary in the sense that first lifetime onset of MDD usually occurs after the onset of at least one other lifetime comorbid disorder. Future efforts such as the NIMH RDoC initiative will be needed to identify the neural circuitry, disease mechanisms, and critical periods underlying depression—information essential to improving our current diagnostic, therapeutic, and prevention strategies. Progress in these areas is sorely needed, as evidenced by the structural impairments that occur subsequent to the onset of MDD, including low educational attainment, poor marital outcomes, and poor socioeconomic outcomes. The day-to-day role impairments that occur in conjunction with MDD include poor performance in both productive and social roles. Increased efforts are needed to document the cost-effectiveness of expanded depression treatment and of treatment-quality improvement initiatives. Because employers play such a large part in driving health insurance benefit design in the United States, it is especially important to document the return on investment of expanded depression outreach and treatment from the employer perspective. We also need to expand research on modifiable barriers to help seeking for depression and to evaluate the effectiveness of systematic depression screening and outreach programs designed to increase the proportion of people with depression who seek treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved