4.3 Article

Prevalence, impairment and severity of 12-month DSM-IV major depressive episodes in Te Rau Hinengaro: New Zealand Mental Health Survey 2003/4

Journal

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY
Volume 44, Issue 8, Pages 750-758

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.3109/00048671003781780

Keywords

cross-sectional survey; diagnosis; impairment; major depressive episode; severity

Categories

Funding

  1. Ministry of Health
  2. Alcohol Advisory Council of New Zealand
  3. Health Research Council of New Zealand
  4. US National Institute of Mental Health [R01MH070884]
  5. John D. and Catherine T MacArthur Foundation
  6. Pfizer Foundation
  7. US Public Health Service [R13-MH066849, R01-MH069864, R01-DA016558]
  8. Fogarty International Center (FIRCA) [R01-TW006481]
  9. Pan American Health Organization
  10. Eli Lilly and Company
  11. Ortho-McNeil Pharmaceutical
  12. GlaxoSmithKline
  13. Bristol-Myers Squibb

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Objective: To assess the prevalence, symptom severity, functional impairment and treatment of major depressive episodes in the New Zealand population, in light of recent criticism that depression is 'over-diagnosed', especially in community surveys Method: Nationally representative cross-sectional household survey of 12 992 adults (aged 16+): The New Zealand Mental Health Survey 2003/4. 12-month major depressive episode measured in face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0) Results: The 12-month prevalence of major depressive episode (MDE) was 6 6% for the total population, with decreasing prevalence with increasing age, and higher prevalence in females (8.1% versus 4.9% in males). Fewer than 10% of 12-month episodes were classified on a symptom severity rating scale as mild, and 69% of all episodes were accompanied by severe impairment in at least one domain of functioning Only a third of those with severe impairment received treatment in the mental health sector, and half saw a general medical practitioner. Conclusion: These results offer little support for the suggestion that depression is over-diagnosed and over-treated, and that current diagnostic thresholds allow the inclusion of too many mild episodes in community surveys.

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