Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study

Karolien E M Biesheuvel-Leliefeld, Gemma D Kok, Claudi L H Bockting, Ron de Graaf, Margreet Ten Have, Henriette E van der Horst, Anneke van Schaik, Harm W J van Marwijk, Filip Smit, DJ van Schaik

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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.

Original languageEnglish
Pages (from-to)139
JournalBMC Psychiatry
Publication statusPublished - 12 May 2016


  • Adult
  • Burden of disease
  • Cohort Studies
  • Cost of Illness
  • Depressive Disorder/epidemiology
  • Depressive disorder
  • Epidemiology
  • Female
  • Humans
  • Male
  • Netherlands/epidemiology
  • Quality of life
  • Severity of Illness Index
  • Subtypes

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