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Outcome of major depression in Ethiopia

Population-based study

Institute of Psychiatry, London, UK

Atalay Alem, MD, PhD

Department of Psychiatry, Addis Ababa University, Ethiopia

Derege Kebede, MD, DSc

Department of Community Health, Addis Ababa University, Ethiopia

Robert Stewart, MD, MSc, MRCPsych, Nick Glozier, MSc, MRCPsych and Matthew Hotopf, BSc, MBBS, MRCPsych, MSc, PhD

Institute of Psychiatry, London, UK

Correspondence: Dr Souci Mogga Frissa, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: S.Frissa{at}iop.kcl.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background The outcome and impact of major depression in developing countries are not clear.

Aims To describe the outcome of major depression and compare the disability and patterns of service use among different outcome groups.

Method In a case cohort study, nested within a population-based survey of 68 000 participants using the Composite International Diagnostic Interview (CIDI), 300 participants were randomly selected from those with current major depression and 300 from those with no lifetime history. Participants were re-interviewed after 18-62 months to ascertain current diagnosis, psychological symptoms, disability and use of health services.

Results Of participants with major depression at baseline 26% also met criteria for major depression at follow up. Mortality ratio standardised for age and gender was 3.55 (95% C11.97 to 6.39). All indices of measure of disability were significantly higher in the persistently depressed group compared with the completely recovered group. Participants who had recovered partially resembled participants with persistent depression. Two-thirds of those with persistent depression had not sought any help.

Conclusions Major depression was associated with mortality and disability. Those with residual symptoms remained disabled. Help-seeking was unusual.

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				P. Tyrer From the Editor's desk The British Journal of Psychiatry, May 1, 2007; 190(5): 456 - 456. [Full Text] [PDF]

				D. Summerfield `Major depression' in Ethiopia: validity is the problem The British Journal of Psychiatry, April 1, 2007; 190(4): 362 - 362. [Full Text] [PDF]