Has the burden of depression been overestimated?
OBJECTIVE
To investigate whether high estimates of the burden of depression could be attributed to an overestimation of disability weights (reflecting more severe disability).


METHODS
We derived disability weights that were tailored to prevalence data. Empirical disability data from a Dutch community survey was used to describe three classes of severity of depression and their proportional prevalence. We obtained valuations from experts for each class and calculated the overall disability weight for depression.


RESULTS
Expert valuations were similar to those of previous studies. The overall disability weight for depression was similar to other studies except the 1994 Dutch Burden of Disease Calculation, which it exceeded by 73%. The lower Dutch 1994 disability weight resulted from an overestimation of the proportion of mild cases of depression by experts (60% versus 27% observed in the empirical data used in the present study).


CONCLUSIONS
This study found no indication that disability associated with depression was overestimated. The Dutch example showed the importance of tailoring disability weights to epidemiological data on prevalence.
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 DR Rotterdam, The Netherlands. m.kruijshaar@erasmusmc.nl
Michelle E
ME
Kruijshaar
Nancy
N
Hoeymans
Jan
J
Spijker
Marlies E A
ME
Stouthard
Marie-Louise
ML
Essink-Bot
D017281:Cost of Illness; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D018434:Sickness Impact Profile