Prevalence and treatment coverage for depression: a population-based survey in Vidarbha, India.
VISHRAM is a community-based mental health program to address psycho-social distress and risk factors for suicide in a predominantly rural population in Central India, through targeted interventions for the prevention and management of Depression and Alcohol Use Disorders (AUD). The evaluation was designed to assess the impact of program on the contact coverage of evidence-based treatments for depression and AUD through a repeated survey design. This paper describes the baseline prevalence of depression among adults in rural community, association of various demographic and socio-economic factors with depression and estimates contact coverage and costs of care for depression.



Population-based cross-sectional survey of adults in 30 villages of Amravati district in Vidarbha region of Central India. The outcome of interest was a probable diagnosis of depression which was measured using the Patient Health Questionnaire (PHQ-9). Data were analyzed using simple and multiple logistic regression.



The outcome of current depression (PHQ-9 ≥ 10) was observed in 14.6 % of the sample (95 % CI 12.8-16.4 %). The contact coverage for current depression was only 4.3 % (95 % CI 1.5-7.1 %). Prevalence of depression varied greatly between the two sites of the study; higher age, female gender, lower education, economic status below poverty line and indebtedness were associated with depression; and while a contact coverage with formal health care was very low, a large proportion of affected persons had consulted family members.



Our findings clearly indicate that psycho-social distress in rural communities in Maharashtra is strongly associated with social determinants such as gender, poverty and indebtedness and affects the entire population and not just farmers.
Centre for Control of Chronic Conditions, Public Health Foundation of India, 19, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh, India. rahul.shidhaye@phfi.org.|CAPHRI School for Public Health and Primary Care, Maastricht University, Masstricht, The Netherlands. rahul.shidhaye@phfi.org.|Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. rahul.shidhaye@phfi.org.
Rahul
R
Shidhaye
Sangath, Goa, India.
Siddharth
S
Gangale
Centre for Control of Chronic Conditions, Public Health Foundation of India, 19, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh, India.|International Mental Health and Wellcome Trust Principal Research Fellowship in Tropical Medicine, London School of Hygiene and Tropical Medicine, London, UK.|Sangath, Goa, India.
Vikram
V
Patel
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
Depression; Health services research; India; Treatment coverage