0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

The Changing Rate of Major Depression:  Cross-National Comparisons

Myrna M. Weissman, PhD; Priya Wickramaratne, PhD; Steven Greenwald, MA; Hsiaoyun Hsu, MS; Robert Ouellette, MPhil; Lee N. Robins, PhD; Javier I. Escobar, MD; Roger Bland, MB; Stephen Newman, MD; Helene Orn, BEd; Glorisa Canino, PhD; Maritza Rubio-Stipec, MA; Hans-Ulrich Wittchen, PhD; Cecilia A. Essau, MA; Carlo Faravelli, MD; Guya Incerpi, MD; Benedetta Guerrini Degl'Innocenti, MD; Leandro Aiazzi, MD; Stefano Pallanti, MD; Jean-Pierre Lépine, MD; Philip Pariente, MD; Joseph Lellouch, PhD; Elie Karam, MD; J. Elisabeth Wells, PhD; Peter R. Joyce, PhD; Mark Oakley-Browne, MB, ChB; John A. Bushnell, PhD; Hai-Gwo Hwu, MD; Eng-Kung Yeh, MD; Ly-Yung Chang, PhD; Gerald L. Klerman, MD; Andrew C. Leon, PhD; Philip Lavori, PhD; Meredith Warshaw, MSS, MA; Wolfgang Maier, MD; Achim Marx, PhD; Drik Lichtermann, MD; Jurgen Minges, MD; R. Heun, MD; Jurgen Hallmayer, MD
JAMA. 1992;268(21):3098-3105. doi:10.1001/jama.1992.03490210080039.
Text Size: A A A
Published online

Objective.  —To estimate temporal trends in the rates of major depression cross-nationally.

Design.  —Nine epidemiologic surveys and three family studies.

Setting and Participants.  —Approximately 39 000 subjects in population-based samples from nine epidemiologic surveys, and 4000 relatives from three family studies that were conducted independently but using similar methodology in the 1980s in North America, Puerto Rico, Western Europe, the Middle East, Asia, and the Pacific Rim.

Outcome Measures.  —Age at first onset of major depression by birth cohort and time period.

Results.  —There was an increase in the cumulative lifetime rates of major depression with each successively younger birth cohort at all sites with the exception of the Hispanic samples, in whom the rates in the older cohort (1915 through 1935) were approximately equal to those of the younger cohorts. However, results of fitting statistical models that separate period and cohort effects showed an overall increase in the rates of major depression over time over all countries, although the magnitude of the increase varied by country. The average relative risk of major depression between a particular cohort and the cohort born immediately before varied between 2.6 (95% confidence interval, 1.8 to 3.7) in Florence, Italy, and 1.3 (95% confidence interval, 1.2 to 1.4) in Christchurch, New Zealand. Short-term fluctuations in the rates of major depression during specific time periods and in specific cohorts also varied by country.

Conclusions.  —Cross-nationally, the more recent birth cohorts are at increased risk for major depression. There are, however, variations in the long- and short-term trends for major depression by country, which suggests that the rates in these countries may have been affected by differing historical, social, economic, or biological environmental events. The linking of demographic, epidemiologic, economic, and social indices by country to these changes may clarify environmental conditions that influence the rates of major depression.(JAMA. 1992;268:3098-3105)

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();