RESUMO
Objectives: Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD. Methods: A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018. Results: Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies. Conclusions: MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
Assuntos
Humanos , Feminino , Criança , Transtorno Depressivo Maior/epidemiologia , Comorbidade , Prevalência , Estado CivilRESUMO
OBJECTIVES: Major depressive disorder (MDD) is one of the most disabling mental illnesses and it has a significant impact on society. This review aims to provide updated scientific evidence about the epidemiology of MDD. METHODS: A systematic literature review of the PubMed and MEDLINE databases was performed to identify articles on the prevalence of MDD and its correlates. The search was restricted to manuscripts published between January 2001 and December 2018. RESULTS: Sixty-three articles were included in the review. The lifetime prevalence of MDD ranged from 2 to 21%, with the highest rates found in some European countries and the lowest in some Asian countries. The main sociodemographic correlates were separated/divorced marital status and female gender. Child abuse, intimate partner violence, and comorbidity with other physical and mental disorders also were consistently associated with MDD across the reviewed studies. CONCLUSIONS: MDD is a highly prevalent condition worldwide. There are remarkable interregional differences in the disorder's prevalence, as well as in certain sociodemographic correlates. MDD is also highly comorbid with physical and mental health problems.
Assuntos
Transtorno Depressivo Maior , Criança , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Estado Civil , PrevalênciaRESUMO
BACKGROUND: Major depression is one of the world's leading causes of disability. Up-to-date information about the epidemiology of this disorder is key to health care planning. AIM: The aim of our study is to report prevalence and correlates of current major depressive disorder (MDD) in the province of Granada, Southern Spain. METHODS: The GranadΣp is a cross-sectional study based on a community-dwelling adult population living in the province of Granada, Southern Spain. Community-dwelling adults aged 18-80 years ( n = 810) were interviewed using the Mini-International Neuropsychiatric Interview (MINI). A variety of exposure assessments were also undertaken. RESULTS: Point (2 weeks) prevalence of MDD in the Granada population was 5.6%. Positive family history of mental illness, high degree of neuroticism, high number of life threatening events (LTE), poor physical health status, cognitive impairment and cannabis use were independently associated with MDD in the multivariate regression model. Being female was also associated with MDD, but the significance disappeared after adjusting for neuroticism and physical health. CONCLUSION: Prevalence of MDD in the Granada population is higher than expected. The effects of the financial crisis could be partially accountable for this excess in prevalence. Six variables were found to be independently associated with MDD. Association between female sex and depression may be partially explained by the confounding effect of neuroticism.
Assuntos
Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cognição , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neuroticismo , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Estudos de Amostragem , Fatores Sexuais , Fatores Socioeconômicos , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Serotonin 1-A receptors are key regulators of serotonin activity and their dysregulation might be implicated in the emergence of both major depression (MD) and generalized anxiety disorder (GAD). Previous studies have yielded inconclusive results as to whether the 5-HT1A receptor gene (HTR1A) has a role in the aetiology of MD and no study up to date has analysed this polymorphism on either pure MD or MD comorbid with GAD. METHODS: In this study, 1059 patients taking part in the PREDICT-Gene study were ascertained for Diagnostic and Statistical Manual of Mental Disorders-IV MD and GAD diagnoses using the Composite International Diagnostic Interview and the Primary Care Evaluation of Mental Disorders questionnaire, respectively. They were also genotyped for the C(-1019)G functional polymorphism at the promoter region of HTR1A gene. RESULTS: Genetic variability at HTR1A was significantly associated with MD [odds ratio (OR) = 1.67; 95% confidence interval (CI) = 1.14-2.44; P = 0.008], although this effect disappeared after adjusting for GAD (OR = 1.43; 95% CI = 0.96-2.14; P = 0.080). Similarly, a crude association between C(-1019)G polymorphism and GAD was found (OR = 2.54; 95% CI = 1.28-4.86; P = 0.003), but these results became no longer significant after adjusting for MD (OR = 1.97; 95% CI = 0.99-3.91; P = 0.050). However, a main effect of HTR1A G(-1019) allele on comorbid MD-GAD was found (OR = 3.41; 95% CI = 1.44-8.05; P = 0.005) and it remained robust and statistically significant after adjusting by sex, age and family history of psychological problems (OR = 2.82; 95% CI = 1.18-6.77; P = 0.020). CONCLUSION: In our study, the HTR1A C(-1019)G polymorphism was found to be associated to the frequent clinical presentation of comorbid MD and GAD, suggesting a common genetic background for mixed depression and anxiety states. These findings should be considered as preliminary. Future replications in independent samples would be needed to confirm or discard such association.
Assuntos
Ansiedade/epidemiologia , Ansiedade/genética , Depressão/epidemiologia , Depressão/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único/genética , Receptor 5-HT1A de Serotonina/genética , Adolescente , Adulto , Idoso , Alelos , Estudos de Casos e Controles , Comorbidade , Demografia , Feminino , Frequência do Gene/genética , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Espanha/epidemiologia , Adulto JovemRESUMO
BACKGROUND: The spastic paraparesis associated to HTLV-1 causes degenerative pyramidal tract lesions of the spinal cord and affects cortical-nuclear connections in the brain. AIM: To report the findings of magnetic resonance imaging in patients with spastic paraparesis. MATERIAL AND METHODS: A magnetic resonance imaging of the brain and spinal cord was performed in 30 patients (24 females), mean age and evolution of 56 and 12 years respectively, with a clinical and virological diagnosis of tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM). RESULTS: No patient had abnormal signals in the spinal cord parenchyma. However, an atrophy of the dorsal segment was observed in 87% of patients. Patients with the highest degree of atrophy showed a higher degree of functional impairment. Eleven patients had spinal cord conus atrophy, associated to neurogenic bladder or impotency. In 80% of patients, hyperintense subcortical white matter images in DP, T2 and Flair, mostly bi frontal, were detected. In half of them, small rounded and isolated images were observed. In the other half, eight or more images, generally larger and occasionally confluent, were found. Ten of 12 patients with confluent brain lesions showed different degrees of cognitive impairment. No patient had lesions in the corpus callosus, periventricular white matter, pons, medulla oblongata or cerebellum. CONCLUSIONS: Most patients with tropical spastic paraparesis have alterations in brain or spinal cord magnetic resonance imaging. The magnetic resonance lesions are concordant with functional impairment. The characteristics of the imaging in TSP/HAM patients can be helpful in the differential diagnosis of patients with paraparesis.