Research report
Major depression in the Era of economic crisis: A replication of a cross-sectional study across Greece

https://doi.org/10.1016/j.jad.2012.08.008Get rights and content

Abstract

Background

The study endeavoured to gauge the impact of the current economic crisis on the mental health of the Greek population. Particularly, it explored changes in the prevalence rates of major depression between 2008 and 2011, and its link to financial hardship. Furthermore, the study also identified potential predictors of major depression in 2011.

Methods

Two nationwide cross-sectional teleophone surveys were conducted in 2008 and 2011 following the same methodology. A random and representative sample of 2.197 and 2.256 people, respectively, participated in the studies. Major depression was assessed with the Structural Clinical Interview, whereas financial strain with the Index of Personal Economic Distress (IPED), an original scale with good psychometric properties.

Results

In 2011, one-month prevalence rate of major depression was found to be 8.2%, as compared to the corresponding rate in 2008, which was 3.3%. Significant increases in prevalence rates were observed for the majority of the population subgroups. A significant association was recorded between major depression and economic hardship. Young people, married persons, individuals with financial distress and people who use medication displayed increased odds of suffering from major depression in 2011.

Limitations

Participants’ responses concerning financial difficulties were not confirmed from collateral accounts. Moreover, the direction of causality between financial hardship and major depression is unclear.

Conclusions

The impact of the economic crisis on the mental health of the population is pervasive. Services and clinicians should focus on the primary prevention of major depression as well as on its timely recognition and treatment.

Section snippets

Background

In the epidemiology of mental illness, and especially affective disorders, a growing body of research has concentrated on the social determinants of depression (Craig, 2010). In particular, various studies have demonstrated a link between the prevalence rates of depression and socio-demographic factors, such as gender, marital status and social support (Alonso et al., 2004, Ayso-Mateos et al., 2001, Brown et al., 1986, Marcus et al., 2005, Wilhem et al., 2003). Furthermore, economic variables,

Participants

The sampling frame of the present study was the national phone-number databank, providing coverage for the vast majority of households in the country. A random sample of telephone numbers belonging to individuals were selected from the directory. Within each household the person who had their birthday last was selected for an interview, while at least 5 callbacks were allowed.

Telephone interviews were conducted on adults aged 18–69 years old during the same time period (February–April). In

Differences in the IPED scores between the two years

In 2011 the sample experienced greater financial distress than in 2008: IPED mean2011=10.97, SD2011=4.46 and mean2008=8.99, SD2008=1.98 with the difference reaching statistically significant levels (p<0.01).

Prevalence and correlates of MDE

One-month prevalence of depression was found to be substantially higher in 2011 than in 2008: 8.2% versus 3.3%, p<0.0001. In terms of risk estimates, the odds of suffering from major depression was found to be 2.6 times greater in 2011 than in 2008 (OR=2.6, 95%CI=1.97–3.43).

Statistically

Discussion

The study adds evidence to the dearth of empirical work on the impact of the economic crisis on the mental health of the general population from a country which has been on the verge of default. In line with this, it provides important insights into the effects of extreme and abruptly changing financial and social states on the prevalence of major depression in a nationally representative sample.

Conclusions

The findings of the present study show a profound and detrimental influence of the economic crisis on the mental health of the Greek population, and especially on the prevalence of major depression. This is of primary concern, if one takes into consideration that depression constitutes one of the main contributors to disease burden and disability worldwide (World Health Organization, 2008). It also confers substantial economic burden in terms of medication, other health care costs and lost

Conflict of interest

The authors do not maintain any financial or personal relationship that might pose conflict of interest in their work.

Role of funding source

The study was self-funded. In particular, it was funded by the University Mental Health Research Institute (affiliation for the 4 out of 5 authors).

Acknowledgments

The authors would like to thank Christos Theleritis for assisting with the manuscript preparation.

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