title: Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study.
abstract: BACKGROUND
  Major depression is the leading cause of non-fatal disease burden. Because major depression is not a homogeneous condition, this study estimated the non-fatal disease burden for mild, moderate and severe depression in both single episode and recurrent depression. All estimates were assessed from an individual and a population perspective and presented as unadjusted, raw estimates and as estimates adjusted for comorbidity.
  
  
  METHODS
  We used data from the first wave of the second Netherlands-Mental-Health-Survey-and-Incidence-Study (NEMESIS-2, n = 6646; single episode Diagnostic and Statistical Manual (DSM)-IV depression, n = 115; recurrent depression, n = 246). Disease burden from an individual perspective was assessed as 'disability weight * time spent in depression' for each person in the dataset. From a population perspective it was assessed as 'disability weight * time spent in depression *number of people affected'. The presence of mental disorders was assessed with the Composite International Diagnostic Interview (CIDI) 3.0.
  
  
  RESULTS
  Single depressive episodes emerged as a key driver of disease burden from an individual perspective. From a population perspective, recurrent depressions emerged as a key driver. These findings remained unaltered after adjusting for comorbidity.
  
  
  CONCLUSIONS
  The burden of disease differs between the subtype of depression and depends much on the choice of perspective. The distinction between an individual and a population perspective may help to avoid misunderstandings between policy makers and clinicians.
authors.affiliation: Department of General Practice and Elderly Care Medicine, and EMGO+ Institute for Health and Care Research, VU University medical centre, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. k.leliefeld@vumc.nl.
authors.forename: Karolien E M
authors.initials: KE
authors.lastname: Biesheuvel-Leliefeld
authors.affiliation: Department of Clinical and Experimental Psychology, University of Groningen, Groningen, The Netherlands.
authors.forename: Gemma D
authors.initials: GD
authors.lastname: Kok
authors.affiliation: Department of Clinical and Experimental Psychology, University of Groningen, Groningen, The Netherlands.
authors.forename: Claudi L H
authors.initials: CL
authors.lastname: Bockting
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Ten Have
authors.affiliation: Department of General Practice and Elderly Care Medicine, and EMGO+ Institute for Health and Care Research, VU University medical centre, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
authors.forename: Henriette E
authors.initials: HE
authors.lastname: van der Horst
authors.affiliation: Department of Psychiatry, and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: van Schaik
authors.affiliation: Department of General Practice and Elderly Care Medicine, and EMGO+ Institute for Health and Care Research, VU University medical centre, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.affiliation: Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.|Department of Clinical Psychology, and EMGO+ Institute for Health and Care Research, VU University and VU University medical centre, Amsterdam, The Netherlands.|Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University medical centre, Amsterdam, The Netherlands.
authors.forename: Filip
authors.initials: F
authors.lastname: Smit
mesh_terms: D000328:Adult; D015331:Cohort Studies; D017281:Cost of Illness; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012720:Severity of Illness Index
keywords: Burden of disease; Depressive disorder; Epidemiology; Quality of life; Subtypes