Epidemiology and Burden of Depression

Depression is a psychiatric disorder in children and adolescents, but it is frequently unrecognized or

dismissed as growing pains. The prevalence of depression is 0.3% in preschool children; 2% in
schoolchildren; and 4-8% in adolescents. Dysthymia is present in 1.7% of children and around 8.0% of
adolescents. Children of both the sexes are equally affected, but in adolescents, females are twice as likely
to be affected as males. The average recovery time from a depressive episode of a children’s life is 9
months, but 10% of those having a major episode may have chronic illness. The average duration of
dysthymic disorder is 3 years. Childhood onset depression has a 60-70% risk of continuing into adulthood
and 20– 40% develop bipolar disorder within 5 years. After a recovery from a major depressive episode,
children might experience abnormality, such as poor self-esteem, increased risk-taking behaviour,
subclinical depressive symptoms, and impairment of interpersonal relations and global functioning.

Thirty to 50% of children with major depressive disorder have comorbid dysthymic or anxiety disorder,
and substance use disorder occurs in 20-30%. Depressed youngsters often have problems at home, and in
many cases, the parents are depressed too, as depression tends to run in many families. Four out of every
five runaway youths suffer from depression. Studies have shown that depression in young people is a risk
factor for suicide, increased risk-taking behavior (e.g. substance abuse, early onset sexual
experimentation), teenage pregnancy, adult depression, conduct disorder, and delinquency. Suicide is one
of the major causes of adolescent mortality in developed countries. In the report of United States, suicide
rates in adolescents have increased threefold during the last 40 years, being the third leading cause of
death in those aged 15-24 years, accounting for 13.7% of deaths in this age group.

Epidemiology of Depression as a Comorbidity

Twenty to fifty per cent of patients with cardiac disease manifest a depressive disorder. An even higher
percentage report depressive symptomatology when self-reporting scales are used. Depressive symptoms
following myocardial infarction have a negative effect on rehabilitation and are predictive of a higher rate
of mortality and medical morbidity.

Depression occurs frequently in patients with neurological disorders, particularly cerebrovascular

disorders, Parkinson disease, multiple sclerosis, and traumatic brain injury. At least 30% of stroke
patients experience depression, both early and late after stroke; such depression is mostly undetected and
untreated. Post-stroke depression (PSD) is associated with poorer recovery from stroke and increased
mortality.
Graph # 2.3: Prevalence
Prevalenceofofmajor
major depression
depression in patients
in patients with with physical
physical illnesses
illnesses
Over 80% of patients with
Alzheimer disease (AD) General Population

develops “ noncognitive” TB

neuropsychiatric symptoms at HIV/AIDS

some point during the course of Cancer

their illness, depression affect

Diseases

Diabetes
20-40% of AD patients.
Stroke
Depression in AD patients leads
to mental suffering, behavioural Epilepsy

MI

Hypertension

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Max Reported Prevalence (%)

Source: World Health Organization. Investing in Mental Health. Geneva: World Health
Organization, 2003
disturbances (such as aggression), poor cognition, poor self-care, caregiver burden, and early entry into a
nursing home. Depression is associated with severe, but avoidable, negative consequences for patients
and caregivers: half of them suffer a major depression themselves.

The prevalence of depression in cancer patients depends on tumour site, severity of illness, and type of
medical or surgical intervention. Depression occurs in 25% of patients, but it can be present in 40-50% of
patients with certain cancers. Initiation of antidepressant medication in cancer patients has been shown to
improve mood and quality of life.

In patients with diabetes mellitus, a common comorbidity in the elderly, the prevalence of depression
varies from 8 to 27%, showing a high correlation between the mood state and the physical symptoms of
illness and the degree of hyperglycaemia.