According to the latest international research on depression it was noted that wealthier nations have a higher rate of the condition.
The global collaborative study looked at depression and social conditions in 18 countries. Results showed that while depression has a similar debilitating effect on people worldwide, wealthier nations tend to have a higher incidence of depression among their citizens when compared with middle-income or poorer nations. The study involved interviewing 89,000 people from countries ranging from high-income nations like France, Germany, Belgium, the United States and Japan, to low-income ones like Colombia, India, China, Mexico and South Africa. On average, 15 percent of the population in wealthier nations suffered from depression over the course of their lifetime as compared with 11 percent for the less wealthy nations. High-income countries had higher rates of major depression (28 percent vs. 20 percent), and especially high rates (more than 30 percent) were found in the United States, France, the Netherlands and India. China had the lowest rate of major depression (12 percent).
The average age at onset of depression was nearly two years younger in low-income countries, the investigators found. Women were twice as likely as men to suffer depression, and the major contributing factor was loss of a partner because of death, divorce or separation.
Lead author on the study Dr. Evelyn Bromet, a professor of psychiatry at State University of New York at Stony Brook said, “We were struck by the difference among high-income and low-income countries. Why this may be the case is the $64,000 question. We don't know for sure.” Depression negatively affected citizens' ability to work, have meaningful relationships and in general live their lives, whether in Ukraine or in Japan.
Dr. Sudeepta Varma, assistant professor of Psychiatry, NYU Langone Medical Center explained the findings saying, “Wealthier nations ... are industrialized nations where individuals rely less on family support for everything from childcare to marital advice. There is a well known link between social support being a protective factor against depression… I also believe that poorer nations may look to religious/spiritual beliefs for comfort, also a protective factor.”
Dr. Gary Kennedy, director of the Division of Geriatric Psychiatry at Montefiore Medical Center said it could have to do with expectations for success and wealth.
Based on detailed interviews with over 89,000 people, the results showed that 15% of the population from high-income countries were likely to get depression over their lifetime with 5.5% having had depression in the last year.
“There's a greater disparity of wealth in higher income nations, so part of what happens is that your expectations are greater. In a sense, you have farther to fall than one might have in a lower-income country,” he said.
Comparing depression rates across different countries is inherently challenging, because survey participants may be influenced by cultural norms or their interactions with the interviewer, says Timothy Classen, an assistant professor of economics at Loyola University Chicago who has studied the link between economics and suicide. “There are significant disparities across countries in terms of the availability and social acceptance of mental health care for depression,” said Classen, noting that there tends to be more stigma surrounding depression in a country like Japan than in the U.S. Classen said this may explain why Japan has a higher suicide rate, even though its depression rates in the study were three to four times lower than those in the U.S.
Authors add however that using interviews to gauge depression may be underestimating incidence of the condition in nations where mental health isn't something that's discussed openly with a foreign interviewer. “The strength and the weakness of our study is that we used the same interview everywhere,” Bomet says. While this makes the data consistent, it may not capture depression as well in lower-income countries where mental health is less widely discussed.
About 121 million people worldwide have depression, which can harm people's quality of life by affecting their ability to work and form relationships. Severe depression can lead to suicide and causes 850,000 deaths every year. The study was published July 25 in the journal BMC Medicine and was conducted in conjunction with the World Health Organization World Mental Health Survey Initiative.
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