Niina Markkula1, Jaana Suvisaari2, Samuli I Saarni3, Sami Pirkola4, Sebastian Peña5, Suoma Saarni2, Kirsi Ahola6, Aino K Mattila7, Satu Viertiö2, Jens Strehle8, Seppo Koskinen5, Tommi Härkänen5. 1. National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, P.O. Box 30, 00271 Helsinki, Finland. Electronic address: niina.markkula@helsinki.fi. 2. National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, P.O. Box 30, 00271 Helsinki, Finland. 3. National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, P.O. Box 30, 00271 Helsinki, Finland; Turku University Hospital, Finland. 4. National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services, P.O. Box 30, 00271 Helsinki, Finland; University of Tampere, School of Health Sciences, Tampere, Finland. 5. National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, Helsinki, Finland. 6. Development of Work and Organizations, Finnish Institute of Occupational Health, Finland. 7. Department of Adult Psychiatry, Tampere University Hospital, Tampere, Finland. 8. Institute for Clinical Psychology and Psychotherapy, Technical University of Dresden, Germany.
Abstract
BACKGROUND: Up-to-date epidemiological data on depressive disorders is needed to understand changes in population health and health care utilization. This study aims to assess the prevalence of major depressive disorder (MDD) and dysthymia in the Finnish population and possible changes during the past 11 years. METHODS: In a nationally representative sample of Finns aged 30 and above (BRIF8901), depressive disorders were diagnosed with the Composite International Diagnostic Interview (M-CIDI) in 2000 and 2011. To account for nonresponse, two methods were compared: multiple imputation (MI) utilizing data from the hospital discharge register and from the interview in 2000 and statistical weighting. RESULTS: The MI-corrected 12-month prevalence of MDD was 7.4% (95% CI 5.7-9.0) and of dysthymia was 4.5% (95% CI 3.1-5.9), whereas the corresponding figures using weights were 5.4% (95% CI 4.7-6.1) for MDD and 2.0% (95% CI 1.6-2.4) for dysthymia. Women (OR 2.33, 95% CI 1.6-3.4) and unmarried people (OR 1.54, 95% CI 1.2-2.0) had a higher risk of depressive disorders. There was a significant increase in the prevalence of depressive disorders during the follow-up period from 7.3% in 2000 to 9.6% in 2011. Prevalences were two percentage points higher, on average, when using MI compared to weighting. Hospital treatments for depressive disorders and other mental disorders were strongly associated with nonparticipation. LIMITATIONS: The CIDI response rate dropped from 75% in 2000 to 57% in 2011, but this was accounted for by MI and weighting. CONCLUSIONS: Depressive disorders are a growing public health concern in Finland. Non-participation of persons with severe mental disorders may bias the prevalence estimates of mental disorders in population-based studies.
BACKGROUND: Up-to-date epidemiological data on depressive disorders is needed to understand changes in population health and health care utilization. This study aims to assess the prevalence of major depressive disorder (MDD) and dysthymia in the Finnish population and possible changes during the past 11 years. METHODS: In a nationally representative sample of Finns aged 30 and above (BRIF8901), depressive disorders were diagnosed with the Composite International Diagnostic Interview (M-CIDI) in 2000 and 2011. To account for nonresponse, two methods were compared: multiple imputation (MI) utilizing data from the hospital discharge register and from the interview in 2000 and statistical weighting. RESULTS: The MI-corrected 12-month prevalence of MDD was 7.4% (95% CI 5.7-9.0) and of dysthymia was 4.5% (95% CI 3.1-5.9), whereas the corresponding figures using weights were 5.4% (95% CI 4.7-6.1) for MDD and 2.0% (95% CI 1.6-2.4) for dysthymia. Women (OR 2.33, 95% CI 1.6-3.4) and unmarried people (OR 1.54, 95% CI 1.2-2.0) had a higher risk of depressive disorders. There was a significant increase in the prevalence of depressive disorders during the follow-up period from 7.3% in 2000 to 9.6% in 2011. Prevalences were two percentage points higher, on average, when using MI compared to weighting. Hospital treatments for depressive disorders and other mental disorders were strongly associated with nonparticipation. LIMITATIONS: The CIDI response rate dropped from 75% in 2000 to 57% in 2011, but this was accounted for by MI and weighting. CONCLUSIONS:Depressive disorders are a growing public health concern in Finland. Non-participation of persons with severe mental disorders may bias the prevalence estimates of mental disorders in population-based studies.
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