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Low prevalence of major depressive disorder in Taiwanese adults: possible explanations and implications

Published online by Cambridge University Press:  04 November 2011

S.-C. Liao ,
W. J. Chen ,
M.-B. Lee ,
F.-W. Lung ,
T.-J. Lai ,
C.-Y. Liu ,
C.-Y. Lin ,
M.-J. Yang  and
C.-C. Chen
S.-C. Liao
Affiliation:
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
W. J. Chen*
Affiliation:
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
M.-B. Lee*
Affiliation:
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
F.-W. Lung
Affiliation:
Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan
T.-J. Lai
Affiliation:
Department of Psychiatry and Institute of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
C.-Y. Liu
Affiliation:
Department of Psychiatry, Chang Gung Medical Center, Linkou Branch, Taiwan
C.-Y. Lin
Affiliation:
Department of Psychiatry, Yuli Veterans Hospital, Haulien, Taiwan
M.-J. Yang
Affiliation:
Dr. Yang's Psychiatric Clinic, Kaohsiung, Taiwan
C.-C. Chen
Affiliation:
Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
*
*Address for correspondence: W. J. Chen, M.D., Sc.D., Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 100, Taiwan. (Email: wjchen@ntu.edu.tw) [W. J. Chen]
(Email: mingbeen@ntu.edu.tw) [M.-B. Lee]
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Abstract

Background

This study examined the prevalence of major depressive disorder (MDD), and the correlations and co-morbid conditions associated with MDD, in the adult Taiwanese population, which a previous estimate in the 1980s had found to be at the lower end of the spectrum worldwide. Possible explanations for the reported low prevalence of MDD were evaluated.

Method

As part of a survey of common psychiatric disorders in a nationally representative sample of individuals aged ⩾18 years who were non-institutionalized civilians in Taiwan, a face-to-face interview using the paper version of the World Mental Health Survey of the World Health Organization (WHO) Composite International Diagnostic Interview (WMH-CIDI) was conducted between 2003 and 2005. Functional impairment and help-seeking behaviors were compared between Taiwanese subjects with MDD and their counterparts in the USA.

Results

Among the 10 135 respondents, the lifetime prevalence of MDD was 1.20% [standard error (s.e.)=0.2%]. Individuals who were divorced or widowed, aged ⩽40 years, and female were at increased risk, whereas rural residents were at lower risk for MDD. The proportion of MDD cases co-morbid with other psychiatric disorders in this study was much lower than in the US study. Only one-third of Taiwanese individuals with MDD sought help despite having twice the number of lost workdays compared with the US sample.

Conclusions

Despite the low prevalence of MDD in Taiwanese adults, the pattern of low help-seeking behavior and profound functional impairment indicates much room for improvement in the early detection of and intervention in major depression in this population.

Keywords

Co-morbiditydepressive disorderprevalenceTaiwanWorld Mental Health Survey
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 6 , June 2012 , pp. 1227 - 1237
Copyright
Copyright © Cambridge University Press 2011

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