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Review article
First published February 2004

Prevalence and Incidence Studies of Mood Disorders: A Systematic Review of the Literature

Abstract

Abstract

This is the second in a series of papers that present systematic reviews of the prevalence and incidence of psychiatric disorders drawn from studies published in English literature in the years 1980 to 2000. The series discusses the implications of these epidemiologic findings to mental health policy and practice.

Objective:

To present the results of a systematic review of literature published between January 1, 1980, and December 31, 2000, that reports findings on the prevalence and incidence of mood disorders in both general population and primary care settings.

Method:

We conducted a literature search of epidemiologic studies of mood disorders, using Medline and HealthSTAR databases and canvassing English-language publications. Eligible publications were restricted to studies that examined subjects aged at least 15 years and over. We used a set of predetermined inclusion and exclusion criteria to identify relevant studies. We extracted and analyzed prevalence and incidence data for heterogeneity.

Results:

Of general population studies, a total of 18 prevalence and 5 incidence studies met eligibility criteria. We found heterogeneity across 1-year and lifetime prevalence of major depressive disorder (MDD), dysthymic disorder, and bipolar I disorder. The corresponding pooled rates for 1-year prevalence were 4.1 per 100, 2.0 per 100, and 0.72 per 100, respectively. For lifetime prevalence, the corresponding pooled rates were 6.7 per 100, 3.6 per 100, and 0.8 per 100, respectively. Significant variation was observed among 1-year incidence rates of MDD, with a corresponding pooled rate of 2.9 per 100.

Conclusions:

The prevalence of mood disorders reported in high-quality studies is generally lower than rates commonly reported in the general psychiatric literature. When controlled for common methodological confounds, variation in prevalence rates persists across studies and deserves continued study. Methodological variation among studies that have examined the prevalence of depression in primary health care services is so large that comparative analyses cannot be achieved.

Résumé

Objectif:

Présenter les résultats d'un examen méthodique de la documentation publiée entre le 1er janvier 1980 et le 31 décembre 2000 qui comporte des résultats sur la prévalence et l'incidence des troubles de l'humeur dans la population générale et dans les établissements de soins primaires.

Méthode:

Nous avons mené une recherche dans la documentation sur les études épidémiologiques des troubles de l'humeur, à l'aide des bases de données Medline et HealthSTAR, et avons parcouru les publications en anglais. N'étaient admissibles que les publications limitées aux études qui examinaient des sujets âgés d'au moins 15 ans et plus. Nous avons utilisé un ensemble de critères prédéterminés d'inclusion et d'exclusion pour déterminer les études pertinentes. Nous avons extrait les données de prévalence et d'incidence, et en avons analysé l'hétérogénéité.

Résultats:

Parmi les études sur la population générale, un total de 18 études de prévalence et de 5 études d'incidence satisfaisaient aux critères d'admissibilité. L'hétérogénéité a été constatée dans toute la prévalence d'un an et de durée de vie du trouble dépressif majeur, du trouble dysthymique et du trouble bipolaire. Les taux pondérés correspondants pour la prévalence d'un an étaient 4,1%, 2,0% et 0,72%, respectivement. En ce qui concerne la prévalence de durée de vie, les taux pondérés correspondants étaient 6,7%, 3,6% et 0,8%, respectivement. Une variation importante a été observée parmi les taux d'incidence d'un an du trouble dépressif majeur, avec un taux pondéré correspondant de 2,9%.

Conclusions:

La prévalence des troubles de l'humeur constatée dans les études de qualité supérieure est généralement plus faible que les taux fréquemment déclarés dans la documentation psychiatrique générale. Lors du contrôle des confusions méthodologiques communes, la variation des taux de prévalence persiste parmi les études et mérite une recherche continue. La variation méthodologique entre les études qui examinaient la prévalence de la dépression dans les services de soins primaires était si importante qu'on ne peut mener d'analyses comparatives.

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Article first published: February 2004
Issue published: February 2004

Keywords

  1. mood disorders
  2. major depression
  3. dysthymia
  4. bipolar disorders
  5. prevalence
  6. incidence
  7. systematic review

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© 2004 Canadian Psychiatric Association.
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PubMed: 15065747

Authors

Affiliations

Paul Waraich, MHSc, MD
Research Associate, Mental Health Evaluation and Community Consultation Unit (MHECCU), University of British Columbia, Vancouver, British Columbia
Elliot M Goldner, MHSc, MD
Associate Professor, Department of Psychiatry, Head, Mental Health Evaluation and Community Consultation Unit (MHECCU), University of British Columbia, Vancouver, British Columbia
Julian M Somers, MSc, PhD
Research Associate, Mental Health Evaluation and Community Consultation Unit (MHECCU), University of British Columbia, Vancouver, British Columbia
Lorena Hsu, MSc
Research Assistant, Mental Health Evaluation and Community Consultation Unit (MHECCU), University of British Columbia, Vancouver, British Columbia

Notes

Address for correspondence: Dr P Waraich, Mental Health Evaluation and Community Consultation Unit, St Paul's Hospital, 306 A-1081 Burrard Street, Vancouver, BC V6Z 1Y6, e-mail: [email protected]

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