title: Outcome of major depression in Ethiopia: population-based study.
abstract: BACKGROUND
  The outcome and impact of major depression in developing countries are not clear.
  
  
  OBJECTIVE
  To describe the outcome of major depression and compare the disability and patterns of service use among different outcome groups.
  
  
  METHODS
  In a case cohort study, nested within a population-based survey of 68,000 participants using the Composite International Diagnostic Interview (CIDI), 300 participants were randomly selected from those with current major depression and 300 from those with no lifetime history. Participants were re-interviewed after 18-62 months to ascertain current diagnosis, psychological symptoms, disability and use of health services.
  
  
  RESULTS
  Of participants with major depression at baseline 26% also met criteria for major depression at follow up. Mortality ratio standardised for age and gender was 3.55 (95% C11.97 to 6.39). All indices of measure of disability were significantly higher in the persistently depressed group compared with the completely recovered group. Participants who had recovered partially resembled participants with persistent depression. Two-thirds of those with persistent depression had not sought any help.
  
  
  CONCLUSIONS
  Major depression was associated with mortality and disability. Those with residual symptoms remained disabled. Help-seeking was unusual.
authors.affiliation: Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. S.Frissa@iop.kcl.ac.uk
authors.forename: Souci
authors.initials: S
authors.lastname: Mogga
authors.forename: Martin
authors.initials: M
authors.lastname: Prince
authors.forename: Atalay
authors.initials: A
authors.lastname: Alem
authors.forename: Derege
authors.initials: D
authors.lastname: Kebede
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Nick
authors.initials: N
authors.lastname: Glozier
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011379:Prognosis