title: Prevalence and risk factors for depression in a rural setting. Results from the North Wales arm of the ODIN project.
abstract: BACKGROUND
  Depressive disorders are common, and result in high individual and societal costs. The majority of research assessing depression has occurred in urban areas. There is a paucity of research examining the prevalence of and risk factors for depression in rural general practice.
  
  
  OBJECTIVE
  The aim of this study was to examine the prevalence of and risk factors for depression in a rural area of North Wales in the context of a large multi-centre European study.
  
  
  METHODS
  One thousand nine hundred and ninety-nine people randomly selected from a health authority database underwent a two-phase screening method to identify depression. The first phase involved patients completing a self-rating postal questionnaire (the Beck Depression Inventory or BDI). In the second phase, those scoring above cut-off underwent detailed diagnostic interview (Schedules of Clinical Assessment in Neuropsychiatry or SCAN). The SCAN diagnostic interview can generate either DSM-IV or ICD-10 diagnoses; the DSM-IV classification system was used here.
  
  
  RESULTS
  One thousand two hundred and thirty-nine (63 %) people responded to the initial screening questionnaire. The prevalence rate for all DSM-IV depressive disorders was calculated to be 6.1 % (95 % CI 4.1, 9.0) whereas the prevalence rate for DSM-IV major depressive disorder was 5.1 % (CI 3.37, 7.66). Multivariate analysis indicated that several variables were related to BDI caseness, including gender, employment status, social support and negative life events.
  
  
  CONCLUSIONS
  Levels of reported depression are relatively low in North Wales compared to those observed in a neighbouring urban area using comparable data collection methods. A number of factors traditionally associated with increased risk from depression were predictive of scoring above cut-off on the BDI in a rural North Wales sample.
authors.affiliation: Division of Clinical Neuroscience, Department of Psychiatry, 2255 Wesbrook Mall, University of British Columbia, Vancouver, BC, V6T 2A1, Canada. emichala@interchange.ubc.ca
authors.forename: Erin E
authors.initials: EE
authors.lastname: Michalak
authors.forename: Clare
authors.initials: C
authors.lastname: Wilkinson
authors.forename: Kerenza
authors.initials: K
authors.lastname: Hood
authors.forename: Janaki
authors.initials: J
authors.lastname: Srinivasan
authors.forename: Chris
authors.initials: C
authors.lastname: Dowrick
authors.forename: Graham
authors.initials: G
authors.lastname: Dunn
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D014852:Wales / Q000453:epidemiology