The epidemiology of major depressive disorder and subthreshold depression in Izmir, Turkey: Prevalence, socioeconomic differences, impairment and help-seeking.
BACKGROUND
Subclinical and clinical depression is common, widely distributed in the general population, and usually associated with role impairment and help-seeking. Reliable information at the population level is needed to estimate the disease burden of depression and associated care needs in Turkey.


METHODS
The cross-sectional study aimed to assess the prevalence of subthreshold (SubD) and clinical major depressive disorder (MDD) in Izmir, Turkey. In the 5242 eligible households, a total of 4011 individuals were successfully interviewed, yielding a response rate of 76.5%. Prevalence estimates of MDD and SubD depression were formed by using the responses to the questions of the CIDI section E. Short Form 36 (SF-36) to assess health status and functional impairments in eight scaled scores during the last four weeks. All respondents were questioned about receiving 12-month treatment for any psychological complaints, the route of help-seeking, as well as prescribed medicines and any hospitalization.


RESULTS
The one year prevalence estimate for CIDI/DSM IV MDD was 8.2% (95% CI, 7.4-9.1). Less educated, low income, uninsured, low SES, unemployed/disabled and housewives, slum area residents had higher one year MDD prevalence. Determined prevalence of help seeking from mental health services of SubD and MDD cases were 23.6%, 30.6% respectively. Only 24.8% of clinically depressive patients received minimally adequate treatment.


CONCLUSIONS
Cross sectional design.


CONCLUSIONS
Higher MDD prevalence correlates with younger ages, female gender, unemployment, less education, lower monthly income, lower SES and uninsurance. Help seeking from mental health services were low. There are treatment gap and impairment in depressive group.
Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey. Electronic address: drtopuzoglu@gmail.com.
Ahmet
A
Topuzoğlu
Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey.
Tolga
T
Binbay
Dokuz Eylul University, School of Medicine, Department of Psychiatry, Izmir, Turkey.
Halis
H
Ulaş
Ege University, School of Medicine, Department of Psychiatry, Izmir, Turkey.
Hayriye
H
Elbi
Ege University, School of Medicine, Department of Public Health, Izmir, Turkey.
Feride Aksu
FA
Tanık
Ege University, Department of Psychiatry, Izmir, Turkey.
Nesli
N
Zağlı
Dokuz Eylul University, Department of Psychiatry, Izmir, Turkey.
Köksal
K
Alptekin
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000191:economics / Q000453:epidemiology* / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D000066505:Help-Seeking Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D062706:Prodromal Symptoms; D012737:Sex Factors; D012959:Socioeconomic Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
Community based; Depression; Prevalence; Sociodemographic; Socioeconomic; Subthreshold